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“ w^uMENTS DEPOSITORY 

Raymond H. Foster Library 
University of Main, at Orono 
'-rono. Maina 04469 







Opinion of George Cooper, Q.C., 
Regarding Canadian Government Funding 
of the Allan Memorial Institute 
in the 1950’s and 1960’s 


The text of the opinion of George Cooper, Q.C., is 
available from Communications and Public Affairs, 
Department of Justice, Ottawa, Ontario, K1A 0H8, 
(613) 996-7192. 


Opinion released with the authorization of the 
Honourable John C. Crosbie, Minister of Justice and 
Attorney General of Canada 

May 1986 


© Minister of Supply and Services Canada 1986 
Cat. No. J2-63/1986 
ISBN 0-662-54427-7 


TABLE OF CONTENTS 


Page 


INTRODUCTION 1. 

1. PROCESS: STEPS TAKEN TO LEARN THE FACTS 

(INTERVIEWS, REVIEW OF FILES, ETC.) 5. 

A . Preliminary 5 . 

B. Problems in digging up information 

20-40 years old 7 . 

C . Limitations to my mandate 8 . 

D. General comments on the interview and 

file review process 10. 

E. Expert opinions 11. 


2. PSYCHIATRIC PROCEDURES IN USE AT THE 

ALLAN MEMORIAL INSTITUTE FROM 1948-1964 12. 

A. General conclusion 12. 

B . The intellectual and scientific basis 
for the procedures of '^depatterning" 

and psychic driving 14. 

C. The procedures involved 16. 

(1) Depatterning and prolonged sleep 17. 

(2) Sensory isolation 18. 

(3) Psychic driving 19. 

(4) Psychoneurotic and schizophrenic patients 20. 

(5) Procedures highly intrusive and intensive 21. 

D. The problem of loss of memory 22. 

E. Dr. Cameron's assessment of depatterning 23. 

F. Psychic Driving - further comments, 

ana t)r. Cameron's assessment 25 . 

G. The use of drugs - further comments 26. 

H. Conclusions on the theoretical basis for 

and the efticacy ot Dr. Cameron's procedures 26 . 


-i- 


Pa g . e . 


3. INVOLVEMENT OF AGENCIES OR DEPARTMENTS OF THE 

GOVERNMENT OF CANADA IN FUNDING THE AMI 29. 

A. National Research Council (NRC) as predecessor 

to the Medical Research Council ( MRC ) 29 . 


(1) No. 290 - Behavioural Laboratory 30. 

(2) No. 217 - Reactions of Civilians to 

Community Disasters 30. 

B. Defence Research Board (DRB) 30. 


(1) Introduction 30. 

(2) The Korean War and "brainwashing" 31. 

(3) Sensory deprivation experiments of 

Dr. Donald 0. Hebb 33. 

(4) Connection between Hebb's work and 

Cameron's work 36. 

(5) DRB funding of projects at the Allan 37. 

C. Department of National Health and 

Welfare ("H&W") 38. 


(1) Introduction 38. 

(2) The form and manner of applying for a 

grant under the Mental Health Grant 39. 

(3) Grants to the Allan Memorial Institute 41. 

(a) Project No. 604-5-14 43. 

(b) Project No. 604-5-432 43. 

(4) The method of dealing with Dr. Cameron's 

grant applications 46. 

(5) Progress Monitoring 48. 

( 6 ) Conclusions 50. 


4. THE CLIMATE OF THE TIMES 51 . 

A. The background to the National Health 51 . 

Grant System 

B. Some Background Data 52. 

C. The state of psychiatry and the growth 
in research after 1948 


53 . 


Page 


5. THE PERSONALITY, CHARACTER, AND PROFESSIONAL 
ACTIVITIES OF DR. D. EWEN CAMERON, AND AN 
ASSESSMENT OF THE QUALITY OF HIS WORK 57. 

A . Persona 1 i t y, character and professional 

a c t i v i ties 5 7 . 


B . An asse s sment of Came ron ' s_ abilities as a 

research scientist ~ 63. 


(1) General conclusion 63. 

(2) The Hawthorne and placebo effects 64. 

(3) The background for the general conclusion 

on Dr. Cameron's abilities as a research 
scientist 68 . 

(4) Reservations of psychologists 69. 

C. Conclusio ns on the qua li ty of Dr. Cameron's 

work ahB~~its~ place in the context of the times 70. 


D . Knowledge held by H&W employees as to the 

quality of t)r. Cameron's research 74 . 


E . Concl usion on the efficacy and propriety of 


reservations ’ 75 . 


(1) Dr. Omond Sol and t 76. 

(2) Dr. Robert A. Cleghom 79 . 

(3) Dr. F.C. Rhodes Chalke 82. 

(4) Dr. Charles A. Roberts 82. 

(5) Mr. John Osborne 83. 

( 6 ) Dr. Craig Mooney, and 

Dr. J.W. Fisher 83. 

(7) Sir Aubrey Lewis 85. 

6 . ETHICAL CONSIDERATIONS SURROUNDING THE 
NATURE AND QUALITY OF DR. CAMERON'S 

ACTIVITIES, AND THE ISSUE OF PATIENT CONSENT 86 . 

A . Ethical standards in medical research 

and experimentation 8 6 . 


B. The question of consent 90 . 


-iii - 


i 


Page 

C . Some developments subsequent to 

br. Cameron^ s tenure at the Allan in 
the matters ot consent and choice of 
treatment 91 . 

(1) The Halushka Case 92. 

(2) The "Patient's Rights" Movement 92. 

(3) The Helsinki Declaration 93. 

(4) Dr. Edmund Pellegrino 93. 

(5) Thalidomide 94. 

7. THE INVOLVEMENT OF THE CIA 95. 

A. General conclusion 95. 

B. The context of the times 97. 

C. Understanding between Canada and the U.S. 97. 

D. The Society for the Investigation 

ot Human Ecology 100 . 

E. Dr. Cameron's grant application to the SIHE 102. 

F. The position of the U.S. government 103. 

G. The CIA and Dr. Cameron's research activities 103. 

H. Conclusions 112. 


8. THE OKLIKOW AND MORROW CASES 113. 

A. The Orlikow case 114. 

B. The Morrow case 115. 


9. LEGAL PRINCIPLES APPLICABLE TO THIS CASE, 

AND CONCLUSIONS OF LAW 117. 

A. Preliminary assumption 117. 

B. Legal analysis 118. 

C. Conclusion 122. 

D. Limitation of Actions or Prescription 122. 

E. Civil Law 123. 


Page 


10. THE WIDER RESPONSIBILITIES OF GOVERNMENT 123. 

A . Further discussion of the "penultimate 
question" - whether Dr. Cameron 'T 

treatments were proper or improper 123 . 

B. The "ultimate" question — the Crown's 

r e spon sl b ll ty 125 . 

11. FINAL CONCLUSIONS 127. 

LIST OF APPENDICES 129. 


-v- 


. 


MclNNES COOPER 8 c ROBERTSON 

BARRISTERS A SOLICITORS 


TELEPHONE AREA CODE 902 
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Lawrence J Hayes, QC 
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James E. Gould 
Eric Dumford 
Peter McLeJIan 
Linda Lee Oland 
Harvey L Morrison 
Thomas E. Hart 
Peter M S. Bryson 
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Deborah K Smith 

COUNSEL: 

John H Dickey O C 


George B Robertson. Q C. 
Reginald A Cluney. O.C. 
John M Davison. Q C 
Joseph A F Macdonald. O I 
David B Ritcey. O.C. 

David H Reardon. O.C 
Robert G Belliveau 
W Wylie Spicer 
John D Stringer 
Gregory J Arsenault 
Brian G Johnston 
K Sara Filbee 
Scott C Norton 
Fae J Shaw 


Lewis A Bell. Q.C. 

Hector Mclnnes. O.C. 
Stewart Mclnnes. O.C 
George T H Cooper. Q C. 
Peter J E. McDonough. Q C. 
George W MacDonald 
Michael I King 
F V.W Panic** 

Christopher C Robinson 
Nicholas A Pittas 
David A Graves 
Gregory H Crosby 
John G Robinson 


P.O BOX 730 
1673 BEDFORD ROW 

HALIFAX, CANADA 

B3J 2V1 

OUR FILE: 


May 3, 1986 


Dear Mr. Crosbie, 


Re: Allan Memorial Institute 


Officials of your department advised me a few 
days ago of your intention to make public my opinion trans- 
mitted to you on March 7, 1986. Because of my undertaking 
to those whom I interviewed in the course of preparing my 
opinion, to the effect that their names would not be 
publicly linked with particular passages in my opinion with- 
out their consent, I thought it best to speak to all those 
affected . 


I am happy to report that in every case, I 
have received their consent. In the course of reviewing the 
particular passages with them, I have incorporated a small 
number of changes in the text of the opinion. All of these 
changes are of an editorial nature and none of them alter in 
any way the substance of what I had been told, or my con- 
clusions thereon. 


Yours very truly. 




rge Cooper 


Honourable John C. Crosbie, 
P.C., Q.C., M.P., 

Minister of Justice, 

House of Commons, 

Room 418 N, Centre Block, 
Ottawa, Canada 
K 1 A 0A6 


GC/mbk 


MclNNES COOPER & ROBERTSON 

BARRISTERS A SOLICITORS 


TELEPHONE AREA CODE 902 
425-6500 
TELEX: 019-21659 
TELECOPIER 425-6386 


Donald Mcmnaa. 0 C. 

Harold F Jackaon QC 
Harry E WirattaJt. QC 
Joaaph AF MacdonaML O.C 
Oavtd B Rrtcay. Q C 
David H. Haardon. Q.C. 
AotartO Bakivaa d 
WWykdSp «ar 
John 0. Sarmgar 
Qragory J. Araanau* 

Bnan a Johnston 
K. Sara Filbaa 
John Q. RoOmaon 
Mauraan E Rato 


Gaorga 6 RoOartaon. OC. 
Reginald A CJunay. O.C 
John M. Dav«aon. Q.C 
Gaorga T.H. Cooper. Q.C. 
Pater J.E McDonough. O.C 
Gaorga At MacOonakJ 

Michael L King 
FV.W Pamck 
Chnatophar C. RoOmaon 
Nicholaa A Pittas 
Oavkj A Gravaa 
Marda L Ruitanbarg 
Deborah K. Smith 


Lewis A Bail. O.C 
Hector Mctnnei O.C 
Lawrence J. Hayes. Q C 
John C Cooper. Q.C 
Jamas E Gould 
EncDumtord 
Peter McLeiian 
Unda Lee dand 
Harvey L Momson 
Thomas E Hart 
Peter M S. Bryson 
Scott C. Norton 
Fee J. Shaw 


IQM»?PC 1° 


KL Li 1 

R E » * i 

JUSTICE 'fiTtW/ 


CABLE AOORESS “Mclnnes" 

PO BOX 730 
1673 BEDFORD ROW 

HALIFAX. CANADA 

B3J 2V1 

OUR FILE: G“1891 

MarcJh 7, 1986 


COUNSEL: 

John H Dickey, Q.C 


Dear Mr. Crosbie, 

Re : Allan Memorial Institute 

I transmit herewith my opinion on this matter. 

Upon undertaking this assignment, I and officials 
of your Department determined that this opinion would 
be subject to the usual solicitor-client privilege. On 
this understanding, and following discussions on the point 
with these officials, I gave assurances of confidentiality 
on behalf of the Department to all those whom I interviewed 
for purposes of ascertaining the facts on which my con- 
clusions are based. I express the hope that this under- 
taking will be fulfilled. 

Should there be anything further I can do in 
connection with this matter, by way of clarification or 
otherwise, I am of course at your disposal. 



P.C. , Q.C. , M.P. , 
Minister of Justice, 

House of Commons , 

Room 418 N, Centre Block, 
Ottawa , Canada 
K1A 0A6 


GC/mtb 

Enclosure 


MclNNES COOPER ft ROBERTSON 

BARRISTERS & SOLICITORS 


TELEPHONE AREA CODE 902 
425*6600 
TELEX 019*21659 
TELECOPIER 425-6386 

CABLE ADDRESS “Mdnne*" 


Donald Mclnnes. Q C 
Harold F Jackson. QC 
Harry E Wrathall. 0 C 
Joseph AF Macdonald. Q C 
David a Ritcey. Q.C 
David H Reardon. Q.C. 
Robert G Belliveau 
W Wylie Spicer 
John D Stringer 
Gregory J Arsenault 
Brian G Johnston 
K Sara Filbee 
John G Robmson 
Maureen E Re»d 


George B Robertson. Q.C 
Reginald A Cluney. Q.C 
John M Davison. Q C 
George T.H Cooper. Q.C 
Petvrr J E. McDonough. Q C. 
George W MacDonald. Q C. 
Michael L King 
FVW Penick 
Chnstopher C Robinson 
Nicholas A Pittas 
David A Graves 
Marcia L Ruitenberg 
Deborah K. Smith 
COUNSEL: 

John H Dickey. Q.C 


Lewis A Bell. Q.C 
Hector Mclnnes, Q C 
Lawrence J Hayes. Q C 
John G Cooper Q C. 
James E Gould Q C 
EncDumtord QC 
Peter McLellnn 
Linda Lee 01. md 
Harvey L Morrison 
Thomas E Hart 
Peter M S Bryson 
Scott C Norton 
FaeJ Shuw 


PO BOX 730 
1673 BEDFORD ROW 

HALIFAX, CANADA 
B3J 2V1 
OUR FILE: 


G-1891 


February 26, 1986 


The Honourable John Crosbie, P.C. M.P. 

Minister of Justice and 
Attorney General of Canada 
Ottawa, Ontario 
K1 A 0H8 

Dear Mr. Crosbie: 

You have asked for my opinion on certain matters related 
to activities carried on at the Allan Memorial Institute 
("AMI") in Montreal during the 1950's and 1960's by Dr. 

D. Ewen Cameron and others, and in particular as to 
whether in the funding of these activities the Government 
of Canada did anything or omitted to do anything which 
might be found to be illegal or improper if an action were 
brought or a complaint made by one or more former patients 


at the AMI 


2 


In December, 1980, nine former patients at the AMI brought 
action against the U.S. Government, claiming damages for in- 
juries suffered by them while under the charge of the AMI 
and particularly Dr. Cameron. They allege that the Central 
Intelligence Agency (CIA) funded Dr. Cameron to perform psy- 
chiatric "experiments" on them without their consent, resul- 
ting in permanent injury. The specific techniques or proce- 
dures alleged are massive electro-shocks, psychic driving, 
drug-induced sleep and the use of controversial chemicals 
such as lysergic acid diethylamide (LSD). These allegations 
form the backdrop of publicity and public concern against 
which my review of the facts underlying this opinion has 
taken place. The Second Amended Complaint of the nine 
plaintiffs is attached as Appendix 1 . A letter from the 
plaintiffs' attorney plus enclosures, which sets out the 
basis of this claim, is attached at Appendix 1A. 

As a result of discussions with J.C. Tait, Q.C., Assistant 
Deputy Minister, Public Law, and M.L. Jewett, Q.C., General 
Counsel, Constitutional and International Law, I understand 
you are seeking both an opinion as to the government's po- 
tential legal liability, and also an opinion as to whether 
the government may be under some duty towards the patients 
of a kind which falls short of legal liability; and, if so, 
what kind of response might be made by the government to 
discharge such moral responsibility. This opinion addresses 


both issues. 


3 


My plan will be to address the following points: 

(1) the steps I have taken to learn the facts; 

(2) conclusions as to what psychiatric procedures were 
actually used at the AMI under Dr. Cameron and his 
associates; 

(3) the involvement of agencies or departments of the 
Federal Government in funding the AMI; 

(4) the climate of the times during which the work of 
Dr. Cameron and his associates was carried out; 

(5) the personality, character and professional 
activities of Dr. Cameron, and an assessment of the 
quality of his work; 

(6) a discussion of the ethical considerations 
surrounding the nature and quality of scientific and 
medical research and experimentation in the 1950's 
and early 1960's, both generally and in relation to 
Dr. Cameron's work, and a comparison with today's 
standards; 

(7) the involvement of the Central Intelligence Agency 
(CIA) ; 


4 


(8) a discussion of the lawsuits conducted in the Quebec 
Superior Court in connection with this matter 
( Orlikow v. The Royal Victoria Hospital and Morrow 
v. The Royal Victoria Hospital ) ; 

(9) a discussion of the legal principles which apply to 
this case, and conclusions of law; 

(10) a discussion of the wider responsibility of the 
government; 

(11) final conclusions. 

I have been assisted throughout by Louis B.Z. Davis of the 
Constitutional and International Law Section of the 
Department and by Mr. Ron Louisseize, Legal Assistant in 
the Civil Litigation Section, as well as by members of my 
firm. The help of all these people has been invaluable. 

I have also been assisted by Dr. G.L. Nelms, Associate 
Chief, Research and Development, Department of National 
Defence; by Dr. Ron Heacock, Director General, Extra-Mural 
Research Programs Directorate, Health Services and 
Protection Branch, Department of Health & Welfare; and by 
Mr. Brian Dickson, Director, Legal Advisory Division, 
Bureau of Legal Affairs, Department of External Affairs, 
together with others in each of those Departments. In 


5 


particular, I have met with J.H. Taylor, Under-Secretary 
of State for External Affairs; D.B. Dewar, Deputy 
Minister of the Department of National Defence; and David 
Kirkwood, Deputy Minister of the Department of Health and 
Welfare. From all of these individuals I have received 
the fullest cooperation. 

1. PROCESS: STEPS TAKEN TO LEARN THE FACTS 

(INTERVIEWS, REVIEW OF FILES, ETC.) 

A. Preliminary 

A preliminary word on the scope of my inquiries is in 
order . 

In your letter of July 26, 1985 and in Mr. Jewett's letter 
of July 29, 1985 your instructions made no specific refer- 
ence to Dr. Cameron. In this opinion I have, however, 
concentrated on Dr. Cameron for a number of reasons. 

First, he was the head of the AMI at all relevant times, 
and its driving force. It was he more than anyone else 
who developed the psychiatric procedures now in controver- 
sy, and he was clearly the leader in their application to 
patients. 


i 


6 


Second, in the actions of the nine U.S. plaintiffs, two of 
whom also brought action in Quebec (Mrs. Velma Orlikow and 
Dr. Mary Morrow), Dr. Cameron appears to be singled out as 
the "guilty party"; indeed in the Morrow case his estate 
was named as a defendant. 

Third, in the course of reviewing the facts necessary for 
purposes of this opinion, I have seen considerable mater- 
ial relating to the work of Dr. Cameron's colleagues at 
the AMI, material that in my opinion is sufficient to give 
a clear picture of the psychiatric work that was carried 
on there. In accordance with usual academic practice, a 
number of colleagues - professors, residents and those 
from other disciplines - were often associated together in 
the same piece of research; usually the names of two or 
more would appear as contributors to the published re- 
sults. Thus, although I have not made special inquiries 
about, or searched for all file material held by govern- 
ment departments or by the Public Archives on, each of 
Dr. Cameron's associates - that task would have taken con- 
siderably more time - I have searched high and wide for 
information on Dr. Cameron; and in so doing, I believe I 
have a clear, if not an absolutely complete, picture of 
the work of his associates as well, at least in the 
relevant subject area. 


7 


B. Problems in digging up information 20-40 years old 

The events in question began to take place at the AMI over 
thirty-five years ago. Three important consequences flow 
from this fact. First, many of the routine administrative 
files in the two key departments (Health & Welfare and 
National Defence) have been destroyed in the ordinary 
course, with the result that I have had to rely a great 
deal upon the recollection of those who were directly in- 
volved at the time. Second, some of those who were 
directly involved have since died, with the result that 
the record is necessarily incomplete in so far as it 
depends upon recollections. Third, many of those still 
living could not be of assistance on points of detail, 
simply because their recollections are no longer precise 
in view of the time that has passed since they were 
actively involved with the subject. 

Nevertheless, I am persuaded that enough factual material 
has been uncovered, both in direct interviews and from the 
files that still exist, to allow factual conclusions to be 
drawn with a high degree of certainty. There is, of 
course, the possibility that new facts might come to 
light, either from government file material not yet un- 
covered, or from individuals now or formerly in the public 
service who might come forward with new information, but I 


8 


consider this possibility to be remote. Consequently, I 
believe I have seen and heard sufficient to conclude that 
all of the important facts that could now be known about 
this subject, and which are in the possession of the 
Government of Canada or any of its departments, agencies 
or employees (past or present), are now known and have 
been taken into account for purposes of this opinion; and 
that it is unlikely that new facts of strong probative 
value will later be uncovered. 

C . Limitations to my mandate 

This conclusion is of course subject (as is the whole of 
this opinion) to the important qualification that the 
scope of my inquiries has been limited by the terms of 
reference stated in both your letter of July 26, 1985 and 
Mr. Jewett's letter of July 29, 1985. In accordance with 
that mandate, and apart from consultations with the three 
independent experts referred to later, I have confined my 
interviews to people having a past or present connection 
with the Government. Similarly, I have confined my file 
search to files in the possession of the Government 
(except that I have also reviewed the files publicly 
available in the Quebec Superior Court in the case of 
Orlikow v. The Royal Victoria Hospital (case no. 
500-05-006872-798), and in the Quebec Superior Court (case 
no. 500-05-738532) and in the Quebec Court of Appeal (case 


9 


no. 500-09-001247-782) in the case of Morrow v. The Royal 
Victoria Hospital ). I have not made any inquiries of peo- 
ple who do not have such a connection, nor (except as 
noted) have I seen any files in the possession of people 
or institutions other than the Federal Government. 

Thus, I have made no enquiries of (for example) former 
patients or staff at the AMI at the time when Dr. Cameron 
was there, and it is of course possible that new facts 
might come to light from that source. (As discussed fully 
later, I did interview Dr. Robert A. Cleghorn at length 
and received very valuable information from him; Dr. 
Cleghorn was a psychiatrist on staff at the AMI, and 
succeeded Dr. Cameron as Director of the Institute in 
1964. I was able to speak to Dr. Cleghorn, not on the 
basis of his association with the AMI, but because of his 
association with the Defence Research Board where, for a 
period prior to 1961, he was Chairman of the Panel on 
Psychiatric Research of the Medical Advisory Committee of 
the Defence Research Board.) I have seen no medical 
records of patients at the Allan. Finally, I have not had 
access to material from the CIA or other U.S. sources, 
except as specifically referred to in this opinion. 


10 


D. General comments on the interview and 
file review process 

Because of the fact that so much file material has been 
lost, I felt it important to interview former government 
employees and also certain people formerly associated with 
research advisory panels but not in the employ of the 
Government. I was also given complete freedom by the four 
Departments involved to speak to those still employed in 
the public service. As a result, I have personally spoken 
to all present and former members of the public service 
still living who had anything substantial to do with any 
of the Government research grants programs in the mental 
health field. In every single case, both present and re- 
tired members of the public service were willing to talk 
at length and without reservation to me, and I have taken 
extensive notes of these conversations. In no case have I 
detected any element of reserve or lack of cooperation. I 
have detected no attempt to hide or gloss over any aspect 
of the questions at issue, and never any attempt to mis- 
lead . 

I should add that I gave assurances to those whom I inter- 
viewed that their comments would not be publicly attri- 
buted to them without their consent. 

I was also given complete freedom to review all of the 
files still available at the Departments in question 
(Justice, External Affairs, Health & Welfare and Defence) 


and at the Public Archives of Canada, and this includes 
files which appeared on the surface to be only marginally 
relevant and which, on closer examination, proved to yield 
no information of any probative value. I have completed 
such reviews. The Department of Veterans Affairs and the 
Medical Research Council also assisted by reviewing their 
files and I am satisfied that these bodies did not fund 
any projects of Dr. Cameron except for one or possibly two 
projects as discussed in section 3 of this opinion. I did 
not review any cabinet documents, and I have no reason to 
believe they would yield any fruitful information. 

A list of those whom I interviewed is attached as Appendix 
2, and a list of the files which I reviewed is attached as 
Appendix 3. 

E . Expert opinions 

I have had the benefit of expert opinions from Dr. 

Frederic Grunberg , Professor of Psychiatry at the 
University of Montreal (and incidentally the current 
President of the Canadian Psychiatric Association) , Dr. 

Ian McDonald, Dean of Medicine at the University of 
Saskatchewan, and Dr. Fred Lowy, Dean of Medicine at the 
University of Toronto. Their expert opinions and 
curricula vitae are attached as Appendices 4, 5, and 6 
respectively . 


12 


2. PSYCHIATRIC PROCEDURES IN USE AT THE 
ALLAN MEMORIAL INSTITUTE FROM 1948-1964 


A. General conclusion 


It is clear that the techniques and procedures alleged by 
the nine plaintiffs in the U.S. law suit were in fact used 
at the AMI, and by Dr. Cameron in particular. That is to 
say, each of the techniques of Electro Convulsive Therapy 
(ECT, sometimes known as Electric Shock Therapy), includ- 
ing massive electric shocks ( "depatterning" ) ; sleep thera- 
py; partial sensory isolation; psychic driving; and 
psychopharmacology (drugs) were used. Most important of 
these was the procedure called by some "Regressive Shock 
Therapy" ( RST ) , and called by Dr. Cameron "depatterning", 
which is perhaps the most controversial of all. 

In stating this conclusion, it will be appreciated that I 
am making no judgment as to the accuracy of any particular 
plaintiff's claim about the use of any one or more of 
these techniques in his or her case, as to the appro- 
priateness of that technique in relation to that parti- 
cular plaintiff's illness, or as to whether, in any 
particular case, the treatment was applied in a proper 
fashion. In accordance with my mandate, I did not address 
any of these issues. The point is simply that there is no 
doubt that Dr. Cameron used all of these techniques at 
various times, and it is certainly within the realm of 


13 


possibility that the plaintiffs received all the treat- 
ments they allege they have received. 

The psychiatric treatments administered at the Allan at 
various times during the 1940's, 1950's and 1960's may for 
present purposes be divided into two categories: 

(1) those in use elsewhere in Canada and the world; 
these included EOT (electro convulsive therapy, 
sometimes called electroshock therapy) , insulin 
coma shock therapy, sleep therapy and drugs 
(including lysergic acid diethylamide, or LSD); 
and 

(2) those in use at the Allan and at a few centres 
in some other countries (but not elsewhere in 
Canada); these included depatterning , psychic 
driving and sensory isolation. 

None of the foregoing psychiatric procedures were pioneer- 
ed at the Allan, and none were unique to it, though the 
procedures of psychic driving and depatterning were devel- 
oped further and continued longer at the Allan than else- 
where. Moreover, the use in combination of the techniques 
of depatterning, psychic driving, sensory isolation, sleep 
therapy and drugs appears to be unique to the Allan. 


14 


A general discussion of the theoretical basis for these 
treatments follows in paragraph B., and a description of 
the actual procedures involved follows at paragraph C. 
Formal descriptions are found in articles published by 
Dr. Cameron in the scientific literature and attached as 
Appendices 7 to 1 7 inclusive. 

B. The intellectual and scientific basis for the 
procedures of "depatterning” and psychic driving 

Dr. Cameron held the view that mental illness was the con- 
sequence of the patient's having learned over the years 
"incorrect" ways of responding to the world around him or 
her . 

The "brain pathways" had thus developed through repetition 
a set of "learned responses" that were not socially 
acceptable and resulted in the patient's being classified 
as mentally ill. 

It had been observed over many years by psychiatrists that 
persons who were subject to convulsions of the brain did 
not become mentally ill. Examples are those who suffer 
from epileptic convulsions, and those who suffer from 
insulin coma. It was speculated that these naturally 
occurring convulsions somehow cleared the "brain pathways" 
and thus eliminated these "incorrect" thought processes. 
From these observations it was deduced that if convulsions 
could be applied artificially to mentally ill patients. 


15 


the "brain pathways" would be broken up and the patient's 
illness would be relieved. This was the fundamental idea 
behind ECT, insulin coma shock therapy and other therapies 
designed to induce convulsions. 

Dr. Cameron took hold of this idea and developed it much 
further than psychiatrists in the mainstream of European 
and North American practice. His idea was to break up the 
brain pathways through the highly disruptive application 
of massive electroshocks, many times the number of shocks 
in a normal ECT treatment - two times a day, as opposed to 
three times a week, for example - until the patient's 
brain had been "depatterned" ; i.e. (in the case of 
psychotic patients) until all schizophrenic symptoms were 
lost, as well as other aspects of memory. After this had 
occurred, the idea was then to "re-pattern" the brain by 
trying to instill new and "correct" patterns of thinking 
in the patient's mind. 

Under Cameron's theory, one might compare the patient's 
brain to an old-fashioned telephone switchboard, in which 
all the wires were plugged into the wrong holes. In 
depatterning , all the wires were pulled out; in 
repatterning, the aim was to plug all the wires back into 
the right holes. 


16 


A second theoretical basis upon which these procedures 
rested was the idea that serious mental illness was the 
result of poor mothering, an idea developed in the U.K. in 
the 1930's and 1940's. If a child could be "re-mothered" 
by a procedure known as "anaclitic therapy", it could be 
cured of the illness. Dr. Cameron in effect applied this 
idea to adults. Through "depatterning" , he had reduced 
the patient's mind to a childlike state; through re- 
patterning, his idea was to "remother" the patient in the 
protected and kindly environment of the hospital. Psychic 
driving was one of the techniques of remothering. 

Dr. Cameron used these two procedures of depatterning and 
psychic driving in treating both psychotic patients 
(schizophrenics) and psycho-neurotic patients. It is 
important to note that, with respect to selection of 
patients in the psychoneurotic category, he said: 

"With regard to selection , we select primarily 
chronic psychoneurotic patients in whom all previous 
forms of therapy have failed." (Appendix 14, p. 210) 
(emphasis in original) 

"The patients selected are almost entirely those 
suffering from extremely long-term and intractable 
psychoneurotic conditions." (Appendix 18, p. 5) 

C. The procedures involved 

Following is a brief description of these treatments, in 
their most highly developed form and taken in combination 
as they sometimes were. 



17 


( 1 ) Depatterning and prolonged sleep 

In depatterning, the patient would be subjected to massive 
electroshock treatments - sometimes up to twenty or thirty 
times as intense as the "normal" course of electro 
convulsive therapy (ECT) treatments. At the end of up to 
30 days of treatment - up to 60 treatments at the rate of 
two per day - the patient's mind would be more or less in 
a childlike and unconcerned state. 

In preparation for the treatment, the patient would be put 
into a state of prolonged sleep for a period of about ten 
days, using various drugs. At that point, the massive 
electroshock therapy would begin, the patient being main- 
tained on continuous sleep throughout. Somewhere between 
the thirtieth and sixtieth day of sleep, and after 30 to 
60 electroshock treatments, depatterning would be 
complete. Depatterning was then maintained for about 
another week, with electroshocks being reduced to three 
per week. 

Gradually the treatments were reduced to one a week. Then 
followed a period of reorganization, when the patient came 
back from the "third stage", through the "second stage", 
up to the "first stage" of depatterning. During this 
period the patient would undergo considerable anxiety; to 
control this, the drugs chlorpromazine (Largactil) and 
sodium amytal were administered. 


18 


The purpose of this procedure, in the case of 
psycho-neurotic patients, was to prepare them for a course 
of "psychic driving". 

(2) Sensory isolation 

An alternative method of preparing patients for psychic 
driving was to place them in situations of "sensory isola- 
tion". This involved depriving them of incoming sensory 
stimulation. This procedure grew out of work carried out 
in the early 1950's by Dr. Donald 0. Hebb, a psychologist 
at McGill, on behalf of the Canadian Defence Research 
Board. Cameron's work with sensory isolation was not a 
continuation of the Hebb work (as suggested by some of the 
media coverage), but was intellectually connected with 
it. Hebb's work is discussed more fully in section 3 of 
this opinion. 

Patients would be placed under conditions of sensory 
deprivation for a matter of days, in one case as long as 
sixteen days. In some cases, patients who underwent 
sensory deprivation without effect were subsequently 
placed under sleep and shock therapy as described above. 


19 


(3) Psychic driving 

Following a course of sensory deprivation, or of sleep and 
shock therapy, or both, the patient would then undergo the 
"psychic driving” procedure. This consisted of messages 
played on tape recorders and repeated thousands of times 
to the patients by means of pillow microphones, steno- 
graphic headphones, and other methods. The idea was first 
of all to deliver a negative signal, designed to get the 
patient to confront his or her inadequacies. (For example: 
"Gertrude, you don't get along with people. You have 
never gotten along with your mother... You have always felt 
inadequate and have been jealous of other people"...). 

This lasted for a period of about ten days, after which 
positive messages would be given for about another 10 
days. (For example: "Gertrude, you want to be free 

like other women. You are trying to give up manipulating 
people by your complaints ... You want other people to 
like you ...You want to have confidence.") 

The content of the messages was usually determined through 
psychological interviews conducted with the patient before 
the treatment began ("autopsychic driving"), sometimes 
while under the influence of disinhibiting drugs. In some 
treatments the messages were based on material developed 
by the psychiatrist rather than the patient 
("heteropsychic driving"). 


20 


Psychic driving would take place for continuous periods of 
up to sixteen hours per day. Taken together, the positive 
and negative messages might be repeated up to half a 
million times. 

Drugs were used throughout the procedure. Barbiturates, 
etc. , were used during the period of prolonged sleep. As 
the patient emerged from depatterning, the anxiety that 
attended the process was relieved by heavy doses of 
Largactyl and sodium amytal. During the psychic driving 
procedure, in order to keep the patient receptive to the 
messages, injections of curare and beeswax would be 
given. LSD was sometimes also administered. 

Throughout the procedure, and for a period of up to three 
years afterwards, a patient would receive intensive 
personal care, both in and out of hospital as required, 
from the hospital staff including social workers, 
psychiatrists, psychologists and nurses. Further electro- 
shocks were administered an average of 65 times during 
this three year period. 

(4) Psychoneurotic and schizophrenic patients 

These procedures were used in treating both psychoneurotic 
and schizophrenic illnesses, although the psychic driving 
technique appears to have been used chiefly with 
psychoneurotic patients. Psychic driving appears not to 


21 


have been generally used with schizophrenics, who were 
repatterned by hospital staff; they spent weeks bringing 
them back to the point where they could lead something of 
a normal life. Prolonged memory deficit was a 
particularly serious problem for both categories of 
patient. 

(5) Procedures highly intrusive and intensive 


It will be appreciated that RST, or depatterning, was a 
highly intensive and intrusive procedure. It was deliber- 
ately aimed at "breaking up the pathways of the brain" and 
thus reducing the brain to an almost infantile state. In 
fact. Dr. Cameron describes the three stages of 
depatterning as follows: 


" In the first stage of disturbance of the space-time 
image, there are marked memory deficits but it is 
possible for the individual to maintain a space-time 
image. In other words, he knows where he is, how 
long he has been there and how he got there. In the 
second stage , the patient has lost his space-time 
image, but clearly feels that there should be one. 

He feels anxious and concerned because he cannot tell 
where he is and how he got there. In the third 
stage , there is not only a loss of the space-time 
image but loss of all feeling that should be present. 
During this stage the patient may show a variety of 
other phenomena, such as loss of a second language or 
all knowledge of his marital status. In more 
advanced forms, he may be unable to walk without 
support, to feed himself, and he may show double 
incontinence. At this stage all schizophrenic symp- 
tomatology is absent. His communications are brief 
and rarely spontaneous, his replies to questions are 
in no way conditioned by recollections of the past or 
by anticipations of the future. He is completely 


22 


free from all emotional disturbance save for a 
customary mild euphoria. He lives, as it were, in a 
very narrow segment of time and space. All aspects 
of his memorial function are severely disturbed. He 
cannot well record what is going on around him. He 
cannot retrieve data from the past. Recognition or 
cue memory is seriously interfered with and his re- 
tention span is extremely limited." 

(Appendix 15, p. 67 ).( emphasis added) 


Other psychiatrists, whose work in RST preceded Dr. 
Cameron's and formed the basis for the work at the Allan, 
described the state of the patient's mind after RST in 
these words (taken from the same article at p. 66): 


"Kennedy and Ancell described their patients as being 
brought to the level of 4-year-old children. 
Rothschild and his co-workers referred to certain of 
their organically disorganized patients as being 
unable to swallow but able to suck fluid from a 
feeding bottle. Glueck reported that his patients 
were like helpless infants. They were incontinent in 
bladder and bowel and required spoon feeding as well 
as tube feeding." 


It will be appreciated that these graphic descriptions of 
the effects of massive electroshock therapy appeared in 
articles published in the open scientific literature. 


D. The problem of loss of memory 

It is well recognized by psychiatrists that simple ECT 
causes in many patients the undesired side effect of 
"memory deficit". For example, a patient after undergoing 
one treatment (a convulsion for perhaps one minute, fol- 
lowed by a half hour or hour of sleep) might temporarily 


23 


forget how to put on and tie shoes. However, after one 
treatment, memory loss is transitory only. After a normal 
course of ECT - say twelve treatments over two or three 
weeks - memory might be lost for a couple of weeks or so; 
on rare occasions, longer. Hospital personnel are, of 
course, trained to help patients put their shoes on, etc., 
in the interval during which the memory is recovering. 

After depatterning , prolonged memory loss was not at all 
unusual, simply because of the massive nature of the 
electroshock applied. All schizophrenic symptoms would be 
lost, as well as other aspects of memory. The resulting 
amnesia was said by Dr. Cameron to be "differential", in 
that amnesia for manifestations of schizophrenia would 
remain, while recollections of ordinary life happenings 
would return during the repatterning process. 

E. Dr. Cameron's assessment of depatterning 

Did depatterning work? Dr. Cameron certainly believed it 
did . In his published article on schizophrenic patients. 
Appendix 15, p. 17, he said: 


24 


"With regard to efficiency, the first question to 
ask is, 'Does it accomplish what is intended?' The 
answer is quite definitely 'Yes'. It has resulted 
in a considerable increase in efficiency over the 
method of multiple shock therapy as introduced by 
Bini and Milligan and modified by subsequent 
workers. It represents, moreover, a noteworthy 
advance over insulin treatment and over the chemical 
therapies. Above all things, the readmission rate 
is greatly reduced. At the same time, we must point 
to the fact that it calls for a most considerable 
expenditure in time and effort and it requires the 
development of a team of workers who are highly 
skilled . (emphasis added) 

"With regard to the detrimental side effects, the 
most serious is of course the period of complete 
amnesia. We are working upon methods to reduce this 
and it is proper to say that while it is a source of 
trouble and annoyance to the patient during the 
first six months or so following discharge, a 
scaffolding of subsequent memories consisting in 
what he has been told of events which happened 
during the amnestic period gradually takes form." 


The underlined passage is important, for reasons discussed 
in section 5 of this opinion. 


It is well to bear in mind that Cameron was not the first, 
nor was he the only, psychiatrist to use depatterning 
techniques. Massive electric shock methods were 
apparently introduced by Cerletti, Bini and Milligan, for 
psychoneurotic patients, and reported in the medical 
literature as early as 1946. The method was transferred 
to the treatment of schizophrenia by Kennedy and Ancell, 
who labelled the treatment (misleadingly, according to 
Cameron) "Regressive Shock Therapy" and reported on it as 
early as 1948. Cameron cites three other groups who used 
the technique, reported in the literature in 1950, 1951 


and 1957 


25 


It was in 1955 that Cameron himself decided, in his words, 
to "develop the potentialities of this procedure". As 
stated above he used the procedure to treat both psycho- 
neurotics (see the application to the Society for the 
Investigation of Human Ecology, Appendix 18, p.5 and the 
articles at Appendices 11, p. 985 and 12, p. 744) and 
schizophrenics (see Appendix 15). 

F . Psychic Driving - further comments, and Dr. 

Cameron's assessment 


Although sometimes used in conjunction with depatterning 
treatments, psychic driving was used in other situations 
as well. As explained, the technique consisted of the 
repetition of tape recorded messages, first of a negative 
kind designed to make the patient face his/her problem, 
and later of a positive kind designed to give the patient 
a new self image. During the "positive" period, the 
hospital staff would work with the patients to encourage 
them to put the new behavioural patterns into practice. 

Dr. Cameron considered that: 

"Our best results have been with chronic 
psychoneurotics - and otherwise untreatable - 
patients, usually with a long standing character 
neurosis, with an anxiety hysteria or an anxiety 


26 


neurosis. With these patients our results have been 
increasingly encouraging, and we now consider that 
this is the procedure of our choice when faced with 
such a case." (Appendix 13, p. 107) (emphasis added) 


G. The use of drugs - further comments i 

Drugs used included barbiturates (such as sodium amytal), 
amphetamines (such as desoxyn) and hallucinogenic drugs < 

such as LSD-25 or mescaline. In addition, as part of the \ 

procedure preparatory to administering massive electro- , 

shock therapy, small doses of curare were administered to j 

produce a state of relative immobility to maintain the ( 

patient in the area of repetition. All these drugs were \ 


in common use by psychiatrists in Canada in the 1950's and ] 

early 1960's. \ 

Because of the public attention that has been focused on * 

LSD, I have added Appendix 19 which will illustrate just | 

how widespread was its use. i 

H. Conclusions on the theoretical basis for and 
the efficacy of Dr. Cameron's procedures 

I 

On the theoretical side, it is now clear to psychiatrists 
generally that Cameron's depatterning , psychic driving and , 

related procedures were not based on sound principles of , 

science or medicine. Psychiatrists no longer accept the 
epileptic/schizophrenia dichotomy; and while there may be 
something in the idea that mental illness is the result of 


27 


poor mothering, Dr. Cameron pushed the idea much too far 
in exploring how it might apply to adults. Even when 
judged by the knowledge and standards of the day, it is 
now seen that the theoretical foundation for Dr. Cameron's 
work was very weak. 

On the practical side, and judging by the standards of 
today, most psychiatrists would conclude that depatterning 
was a failure not only in terms of its efficacy as a 
medical treatment, but also in that it represented a level 
of assault on the brain that was not justifiable even by 
the standards of the time and even in light of the rather 
rudimentary level of scientific and medical knowledge of 
those days compared to today. 

These conclusions are, however, evident only with the 
benefit of hindsight; and no medical doctor I spoke to 
was prepared to state that Cameron's depatterning 
procedures were conducted in disregard of the limits of 
acceptable medical practice at the time, or otherwise than 
out of desire to benefit the patients involved. These 
points will be elaborated in sections 5 and 6 of this 
opinion, but for the moment it should be noted that some 
doctors felt that, as a man driven to try to find 
solutions to the problems of mental illness, both in 
general and for particular patients. Dr. Cameron may have 
allowed himself subconsciously or unintentionally to go 


28 


3 

beyond those bounds with respect to some particular 

patients; but this is of course speculation and, to ^ 

repeat, none of these doctors were prepared to attribute q 

any improper motive. C 

C 

At the same time some individual doctors had doubts about D 

the efficacy of the depatterning and psychic driving a 

procedures during Dr. Cameron's tenure at the Allan; in 0 

fact these procedures were not free from controversy even a 

within the Allan itself. However, these doubts took the 
form of "mutterings" . Although everyone at the Allan, and 
most psychiatrists in Canada, knew about Cameron's work, 

and it was fully described in the open scientific T 

literature for all to see, no one spoke out publicly q , 

against it. It is also worthy of note that Cameron's ^ 

treatments were not used by his colleagues in psychiatric ^ 

practice in other hospitals in Montreal, including those g 

within the McGill teaching hospital system, in spite of *, 

Cameron's position as professor of psychiatry. They 

tolerated his techniques, but they did not adopt them. C 

A discussion of these contemporary doubts will be found in r 

section 5 of this opinion. 

I 

N 

t 


29 


3. INVOLVEMENT OF AGENCIES OR DEPARTMENTS OF THE 
GOVERNMENT OF CANADA IN FUNDING THE AMI 

Three agencies of the Government of Canada funded Dr. 
Cameron for various projects: the National Research 

Council ( NRC ) as predecessor to the Medical Research 
Council (MRC), the Defence Research Board (DRB), and the 
Department of National Health and Welfare (H&W). The DRB 
also funded other relevant research at McGill in the field 
of sensory deprivation. The activities of these agencies 
are discussed in turn. 

A. National Research Council (NRC) as predecessor 
to the Medical Research Council (MRC) 

The National Research Council, through its Associate 
Committee on Medical Research, made a grant to Dr. Cameron 
in 1944-1946 to study "psychological aspects of return to 
industrial civilian life" after the World War II. The 
grant number was M.P. 38, and the grant amounted to $3,000 
for each of the two years. 

Clearly this grant is *not relevant to the matters under 
review in this opinion. 

I have discovered a list (attached at Appendix 19A) of 
NRC Grants-in-aid for psychiatry, showing two other grants 
to Dr. Cameron. They are: 


30 


(a) No. 290 - Behavioural Laboratory - f 

$4,197.00; h 

d 

(b) No. 217 - Reactions of Civilians to i 

Community Disasters - $650.00. ° 

r 

The first is an amount identical to the funding during m 

1950/51 from Health and Welfare to Dr. Cameron for Health r 

and Welfare's Project No. 604-5-14, "Support for a w 

Behavioural Laboratory" (see later). I can find no other & 

information on NRC Project No. 290. From the figures, I r 

assume that either NRC gave a matching grant during the s 

one year in question, or Health and Welfare simply paid s 

the money on N.R.C.'s behalf. Nothing of significance c 

here turns on this grant. 

As for No. 217, Reactions of Civilians to Community 

Disasters, this obviously represents a grant supplementary 1 

to DRB's grant No. 65 to Cameron (see later). Again, - r 

there is no further information in the file, and again, 13 

nothing of relevance here turns on this grant. * 

V 

B. Defence Research Board ( DRB ) t 

i c 

(1) Introduction 

The DRB was founded in 1946 as the research arm of the 1 

Department of National Defence. Dr. Omond Solandt was the 


31 


first Chairman, and he remained Chairman until 1957 when 
he was succeeded by Adam Hartley Zimmerman, Sr. (now 
deceased). The mandate of the DRB was to engage directly 
in research of its own, to contract out for specific items 
of research work, and to make grants to independent 
researchers, in areas of particular application to the 
military. The DRB was not to conduct basic scientific 
research, but rather applied research. Included in this 
was research in psychiatry and psychology, primarily to 
develop methods of testing the capabilities of potential 
recruits and serving personnel, to determine their 
suitability to withstand the stress of combat, and to 
study the effect of stress generally in the trying 
conditions of war and other emergencies. 

(2) The Korean War and "brainwashing" 

In the early 1950's there was great concern in the senior 
ranks of the military in Canada, United States and the 
United Kingdom about the new "brainwashing" techniques 
then being used by communist forces during the Korean 
War. Troops from these three countries who were captured 
during battle were sometimes subjected to these techniques 
and as a result were forced to make public statements, or 
"confessions", in which they renounced the beliefs and 
values of their own country and then espoused publicly 
those of the adversary. In certain cases there appeared 


32 


to be no physical coercion which could have accounted for se 

this behaviour, and often the confessions seemed to be on 

quite voluntary and genuine. Reports came back as to the 
way in which these confessions were extracted; troops had 
been subjected to long spells of isolation, followed by 

periods of indoctrination to the new beliefs. One such gh 

report is attached as Appendix 20. These techniques gave i n 

rise to real concern on the part of the western allies He 

that the communists had discovered some new way of con- <rt 

trolling the mind. They concluded that it was essential p t 

to find out everything that could be learned about these 

methods, so that our troops could be told in advance of b< 

communist techniques and, to the extent possible, trained ■)< 

to withstand brainwashing. M< 

A high-level meeting took place at the Ritz Carlton Hotel p 

in Montreal on June 1, 1951 to discuss the problem. c 

Present were representatives of the scientific research m 

establishments of the Canadian, the U.S. and the U.K. t 

military. Dr. Solandt was Canada's chief representative. b 

Dr. Donald 0. Hebb, a psychologist from McGill University, t 

was also present and proposed to the group that experi- s 

ments in "sensory deprivation" might be carried out to b 

determine whether something of the communists' brain- t 

washing techniques might be learned. Attached at Appendix c 

21 is a copy of the minutes of the June 1, 1951 meeting; \ 

the handwritten note appended to these minutes (found f 

I 


33 


separately in DRB files) suggests that Commander Williams, 
one of those in attendance, was with the CIA. 

(3) Sensory deprivation experiments of 
Dr. Donald 0. Hebb 

Shortly after the meeting of June 1, 1951, the DRB entered 
into a contract (designated the X-38 Project) with Dr. 

Hebb to conduct these "sensory deprivation experiments". 
The purpose of the work was to establish whether indeed 
prolonged periods of sensory deprivation reduces the sub- 
ject's resistance to accepting new beliefs contrary to 
beliefs previously held. The work continued from 1951 to 
1955 and involved some 63 paid volunteers, students from 
McGill University. 

Dr. Hebb's practice was to place his subjects in a small 
cubicle in which external stimulae were kept to a 
minimum. The forearms would be covered with cardboard 
tubing, cotton wool would cover the hands, glasses would 
be worn which permitted only diffused light to enter, and 
there would be no auditory stimulation. The student would 
spend as much time in this situation as could reasonably 
be accepted, and was free to leave at any time. While in 
this state of sensory deprivation, the subject would be 
offered the opportunity of hearing material distasteful to 
him or her, through gramophone recordings. An extract 
from some of Hebb's earliest work will illuminate the 
point: 


34 


"Three gramophone recordings were available to the 
subject, all with material the subject found unplea- 
sant at the beginning of the experiment: (1) four 

repetitions of 16 bars from "Home on the Range"; (2) 
a 5-min. extract from a harsh atonal piece of music; 
and (3) an excerpt from an essay instructing and 
exhorting young children on the methods and desir- 
ability of attaining purity of soul. S could signal 
for any of these three. He signalled 42 times alto- 
gether, and spent a total time, listening to this 
material, of 2 hours and 21 minutes out of his 8$ 
waking hours. He was mostly unselective in his 
choice, usually requesting all three, one after 
another, and then, after a pause, going through them 
again. The only sign of preference was for (1) 
repeated bars from "Home on the Range". This subject 
is a college student, in the superior adult class 
intellectually, and this is not the kind of material 
that would be in any way entertaining to him. As 
noted above, he disliked the material to begin with, 
and reported that he still disliked it when the 
experiment was over." 


Alternatively, the researcher might feed to the student 
a line of "propaganda" contrary to his or her own beliefs, 
to see if he could get the student to espouse that 
belief. The beliefs in question were quite innocuous - 
for example, a belief in the biblical account of creation, 
or a teetotaller's view. At Appendix 22 are copies of 
some DRB file materials on this research. 


Although the work carried out by Dr. Hebb was originally 
classified, it has long since been declassified. Through- 
out most of the period when the work was being done, Dr. 
Hebb himself repeatedly implored the DRB to allow him to 
publish it. He also believed that failure to do so would 
result in the public getting the wrong impression when the 


35 


material did eventually leak out, as it inevitably would. 
Attached at Appendix 23 are some file materials, news 
clippings and correspondence which make the point well. 

The conclusions reached by Dr. Hebb and his associates may 
be simply stated. A changing sensory environment is abso- 
lutely essential to the good health of the mind. Without 
it, the brain ceases to function in an adequate way, and 
abnormalities of behaviour develop; for example, the sub- 
ject quickly begins to hallucinate. By "softening up" 
a prisoner through the use of sensory isolation techni- 
ques, a captor is indeed able to bring about a state of 
mind in which the prisoner is receptive to the implanta- 
tion of ideas contrary to previously held beliefs. At 
Appendix 24 is a three page summary of these results pre- 
pared by DRB for Treasury Board on August 3, 1954. 

Dr. Hebb, who died in August of 1985, was Canada's fore- 
most psychologist, and the author of the seminal textbook. 
The Organization of Behaviour (1949). He was regarded as 
a very fine scientist and a humane and thoughtful person. 
He conducted his research with the highest regard for the 
welfare of the volunteer students. I have heard no sug- 
gestion of any impropriety in the conduct of his 
research. One person told me of an unconfirmed report 
that one student developed a form of mental illness 
following the experiment, but the suggestion is that the 


illness was incipient in any event, and would have 
resulted regardless of Dr. Hebb's experiments. 

As predicted by Dr. Hebb, his work did eventually leak out 
and become the subject of adverse press comment. As a re- 
sult, Dr. Solandt was asked for an explanation, and then 
required to phase out the research. Appendices 23 and 24 
give the background to this aspect of the matter. 

(4) Connection between Hebb's work and 
Cameron's work 

Dr. Hebb's work is mentioned in this opinion because some 
media reports, and some members of the public who have 
written to the government to express concern about Dr. 
Cameron's work, have referred to Hebb's work evidently in 
the belief that there was a close connection between the 
work of the two men. Dr. Cameron, being in close physical 
proximity to Dr. Hebb, was, of course, aware of Hebb's 
work and was himself interested in sensory deprivation 
from a psychiatric perspective. This is made clear in 
Hebb's letter of January 1, 1953 in Appendix 23^ So were 
others at the AMI, as is shown by the letter from Dr. 
Cormier attached as Appendix 25. However, as stated 
earlier, the work of Drs. Cameron and Hebb are connected 
only in an intellectual sense; Cameron's work was not at 
all a . continuation or an elaboration of Hebb's work. 
Cameron was often stimulated by the work of other 


37 


scientists in related or even unrelated fields, and 
sensory deprivation was just one of the new research ateas 
in which he took an interest. 

Hebb himself was contemptuous of Dr. Cameron's work in the 
field of sensory deprivation ( as well as his work in 
psychic driving), so I was told by a number of the people 
I interviewed. In Hebb's opinion, Dr. Cameron did not 
have the necessary background in the principles and 
techniques of scientific investigation to understand 
properly how (if at all) Hebb's work in sensory isolation 
could be utilized in the treatment of patients. The 
question of Dr. Cameron's abilities as a research 
scientist is discussed fully in section 5 of this opinion. 

(5) DRB funding of projects at the Allan 

The DRB funded two research projects of Dr. Cameron. 
However, neither of these projects were related to the 
treatment of mental patients. The two projects in 
question (DRB grant Nos. 65 and 172 respectively) were 
entitled "Management of Fear and Anxiety by Civilians in 
the Event of a Community Disaster" (1948-1951) and 
"Behavioural Problems in the Adaptation of White Man to 
the Arctic". For an important reason discussed in section 
5 of this opinion, the Chairman of the DRB, Dr. Solandt, 


38 


ensured that Cameron made no applications to the DRB for Me 

work in the area of psychiatric research dealing with HS 

patients. wt 

Me 

The DRB funded a considerable number of other research 

projects at the Allan, projects conducted by associates of Tl 

Dr. Cameron. I have coincidentally examined quite a lot d] 

of file material relating to these projects; none of it 

bears on the issues under review in this opinion. I have 

not considered it necessary to look further for DRB 

funding of psychiatric research involving patients at the 

Allan, for two reasons: first, in so far as Dr. Cameron is T1 

concerned, as mentioned above the DRB at Dr. Solandt's m. 

direction declined to consider any application that might Gi 

be made; second, in so far as others at the Allan are v, 

concerned, I have no reason to believe that they would f< 

apply for, or receive, grants in the fields of activity 
under review here (namely depatterning , psychic driving 
etc.), which were peculiarly Dr. Cameron's fields. 


C . Department of National Health and Welfare ("H&W") 


( 1 ) Introduction 


In 1948 the federal government established the National 
Health Grants program to provide funds for health care in 
ten (later, thirteen) health areas. One of these was the 


39 


Mental Health Grant. Research grants made to the Allan by 
H&W during the period under review (from 1948 to 1964, 
when Dr. Cameron left the Allan) were made under this 
Mental Health Grant. 

The background of the National Health Grants program is 
discussed in section 4 of this opinion. 


(2) The form and manner of applying for a 
grant under the Mental Health Grant 

Throughout the period with which we are concerned, the 
manner in which grant applications under the Mental Health 
Grant were handled was as follows (see Appendix 26 for 
various departmental memoranda and a sample application 
form) : 


(a) The institution (e.g. the AMI) would make an 
application in the form required by H&W, and 
then submit the application to the 
provincial authorities. 

(b) The provincial authorities would then 
signify their approval of the application by 
forwarding it to H&W in Ottawa. 


40 



(c) H&W officials would review the application 
in a preliminary way to satisfy themselves 
generally as to the scientific and medical 
adequacy of the proposed research, and to 
ensure that all formalities had been 
attended to. 

(d) The application would then be referred to 
two outside experts in the particular field 
of the proposed research. These experts 
would give detailed written commentary back 
to the Department. The comments would at 
all times remain anonymous. 

(e) The Research Subcommittee of the Mental 
Health Advisory Committee would review each 
application to ensure its scientific and 
medical adequacy. The Mental Health 
Advisory Committee numbered about twenty. 

It was composed of experts drawn from 
outside the public service and involved in 
the disciplines of psychiatry, psychology 
and related fields. People from within the 
Department would sit as chairman and 
secretary of the committee to provide the 
necessary liaison. The committee therefore 
acted as a form of peer review. 


■ 


41 


(f) The Subcommittee would report its 
recommendations to the full Advisory 
Committee, who would then report to 
departmental officials. 

(g) Departmental officials would then recommend 
the grants to the Minister, who would then 
send his approval back to the province. 

(h) The provincial officials would then approve 
the grant directly to the institution. 


(3) Grants to the Allan Memorial Institute 

I turn now to discuss the grants for psychiatric research 
made under the Mental Health Grant to the Allan Memorial 
Institute and to Dr. Cameron. 

In early 1985, the Department of Health and Welfare re- 
ceived an access to information request for "All letters 
and reports between 1950-64 relating to Dr. Cameron's and 
Allan Memorial Hospital's experiments in regards to pro- 
ject MK Ultra, Human Ecology, Brainwashing, and any let- 
ters and reports sent to the Central Intelligence Agency 
(CIA), USA". In answering, the Department consulted its 
master index, which lists nine psychiatric research pro- 


42 


jects for which Dr. Cameron is named as principal investi- 
gator. Total funds for these nine projects amounted to 
$495,444.41; the nine projects are listed in Appendix 
27. In addition to these nine projects, I have identified 
a tenth project, No. 604-5-433, which began in Dr. 
Cameron's name and finished in 1965 in the name of a Dr. 
Davis, Cameron having by then retired. This project is 
entitled "The Influence of Psychotropic Drugs upon 
Cerebral Responses to Peripheral Stimulation in Man". 

I have reviewed files on eight of these ten projects. (No 
files exist for the other two, Nos. 604-5-104 and 
604-5-108, but from their titles as given in Appendix 27 
it is apparent that they are not relevant here.) Of these 
eight, it appears on examination that Dr. Cameron was the 
principal investigator in only four; in fact, not only was 
he not the principal investigator in the other projects 
(contrary to the indication in the H&W master index), but 
his name is not even mentioned in the project files still 
available. It is speculated that, as head of the Allan, 
he signed the original project applications although not 
himself a participant. 

Of the four projects in which Cameron was in fact prin- 
cipal investigator, only two are relevant here (the other 
two are No. 604-5-76, "A Study of the Effects of Nucleic 
Acid Upon Memory Impairment in the Aged", and No. 
604-5-433, referred to above). The two relevant files are: 


43 


(a) Project No. 604-5-14 (1950-1954; $17,875.00) 

Under this project, entitled "Support for a 
Behavioural Laboratory”, a number of experi- 
ments were planned. One was to test memory 
and learning impairment due to individual 
and cumulative electric shock. Another was 
to film patients against a checkered back- 
drop before and after ECT treatment, to see 
if any differences in physical movements 
could be detected. A third was to study the 
effects of sensory isolation. A fourth was 
to investigate psychic driving techniques in 
various situations: while the patient was 

under hypnosis, in continuous sleep, and 
when the patient's resistance was lowered 
using the isolation techniques of Dr. Hebb. 
The final report to H&W is reproduced at 
Appendix 28. 

(b) Project No. 604-5-432 (1961-1964; $51,860.00) 
This project is entitled "Study of Factors 
which Promote or Retard Personality Change 
in Individuals Exposed to Prolonged Repeti- 
tion of Verbal Signals"; i.e. psychic 
driving. Copies of the summary and final 
report are attached at Appendix 29. This 


44 


study gave rise to five published papers, 

four of which are reproduced at Appendices e * 

13, 14, 16 and 17. 

Ir 

It will be seen that both these projects had to do with Hl 

psychic driving, used in combination with the procedures S€ 

of depatterning , sleep therapy and drugs. As will be seen *!< 

in section 7, these were also the subjects of investiga- a 

tion in the research work carried out by Cameron with CIA ol 

funds. be 

di 

A further word on one of the apparently unrelated 
projects. No. 604-5-13, "Research Studies on EEG and 

Electrophysiology", is in order. This was an extensive c * 

project conducted at the Allan primarily by Dr. Lloyd 
Hisey, Psychiatrist in Charge, Electroencephalographic and 
Electrophysiological Centre (1950-1952) and his successor 

as of July 1, 1952, Dr. Charles Shagass. Much of this a 

work, of which there are extensive reports published in c< 

the scientific literature, was supported by both H&W and 

DRB . Although these studies deal with specific aspects of ei 

psychiatric research, none of them bear directly on the r ' 

topics of depatterning and psychic driving. The work did, ° 

however, cover topics such as photic stimulation (the use _ 

f 

w 

t 


45 


of strobe lights)*, drug induced sleep and studies of the 
effects of electroshock (see Appendix 30). 

Interestingly enough, the Society for the Investigation of 
Human Ecology (SIHE), the CIA "cover organization" (see 
section 7 of this opinion) was also interested in Project 
No. 604-5-74 , "A Study of Ultraconceptual Communication", 
a 1959-61 study under the direction of Leonard Rubenstein 
of the Allan (see Appendix 31). (Rubenstein was a colla- 
borator with Cameron on the SIHE project on psychic 
driving under the CIA's code name "MK Ultra Subproject 
68", discussed in detail later). I have seen no suggestion 
that the SIHE provided actual financing for this parti- 
cular project, although it is conceivable that the CIA may 
have been interested in the subject matter of the project, 
dealing as it did with an examination of the ways in which 
the voice can communicate information on both a verbal and 
a non-verbal level, and can also convey feelings either 
consciously or unconsciously which are either allied to 
the verbal communication or reflect the speaker's 
emotional disposition. In any event, this project is not 
relevant to the subject matter under review in this 
opinion. 

*Strobe lights, when flashed on and off at certain 
frequencies, can bring on convulsion-like effects; thus it 
was thought that the technique could assist in clearing 
the "brain pathways". 


46 




In addition to these ten projects, there were of course 
many other grants made to other researchers associated 
with the AMI. Although I have not reviewed the files 
relating to these grants - indeed, to do so would have 
taken considerably more time and would have entailed a 
considerable enlargement of my mandate - I have reviewed 
H&W's list of projects funded between 1948 and 1963, and I 
have no reason to think that any of them have a bearing on 
the subject matter of this review. 

(4) The method of dealing with Dr. Cameron's 
grant applications 

Were Dr. Cameron's grant applications handled by the 
Department of National Health and Welfare in the same way 
as other applications? 

A number of people I interviewed had been present at 
meetings of the Research Sub-Committee of the Mental 
Health Advisory Committee and recalled the fact that 
Cameron had indeed made application to the Mental Health 
Division for grants. However, none of them had any 
recollection of the particulars of these applications or 
of the ensuing grants. All those to whom I spoke advised 
that Dr. Cameron's applications would have been treated in 
the normal way; had this not been the case, they would 
have remembered the fact. 


i 


47 


At the same time, it was recognized by those I interviewed 
that Cameron was looked upon as the doyen of Canadian psy- 
chiatrists. In the view of many of them. Dr. Cameron's 
pre-eminence in his field, added to his forceful and 
aggressive personality, may well have resulted in a cer- 
tain deference being shown to his applications by those 
whose task it was to review them. There is no suggestion 
that anyone shirked responsibility and let pass a research 
project considered to be scientifically or medically 
unacceptable, nor is there any suggestion that there was 
not lively debate at the intellectual level when 
applications were being reviewed; indeed this seems to 
have been the norm even when applications of eminent 
people such as Dr. Cameron were being considered. What is 
suggested is that it is likely that some members of the 
reviewing groups may have been somewhat reluctant to 
express doubts, if indeed they had any, about the medical 
or scientific basis for the procedures under review in the 
proposal. It is to be emphasized that there is no actual 
evidence that this occurred; but human nature being what 
it is, it is in the view of some to whom I spoke 
reasonable to assume that this kind of deference could 
occur. 

In summary, there is no evidence that the applications of 
Dr. Cameron and the AMI were treated in any different 


48 


manner by the government and its outside consultants than 
applications from any other quarter. 

(5) Progress Monitoring 

It was the Mental Health Division's practice to require 
grantees to submit an annual progress report. In fact, 
the grants themselves were made on an annual basis, while 
more often than not the project was intended from the 
beginning to last for a period of years. It was on the 
basis of these annual progress reports that the grant for 
subsequent years was approved by the Mental Health 
Advisory Committee. 

In addition to this, it was the Department's practice to 
send representatives on occasional visits to the 
institutions where the work was being carried out; but 
because health is primarily a matter falling under 
provincial jurisdiction, departmental officials would ask 
permission of their provincial counterparts to make the 
visit. This permission was invariably granted, and 
certainly in Quebec the work of checking up on ongoing 
projects was carried out entirely by federal, not 
provincial, officials. But the point is that the federal 
government at all times "cleared the way" for the visits 


49 


of federal personnel to the grantees' institutions. The 
visitors would also obtain the permission of the institute 
itself in advance of the visit; there was no suggestion 
of "surprise visits". Moreover, the visit was not in the 
nature of an inspection; it did not constitute a detailed 
financial, medical or scientific audit. It was simply a 
matter of the Mental Health Division representative 
hearing from the investigator about the work that was 
being conducted under the grant, so as to be in a position 
to evaluate the annual application for renewal and also to 
ensure that the grant money was being spent generally on 
the project for which the grant was intended. 

So far as Dr. Cameron and the AMI are concerned, there is 
no evidence that the annual visits were treated any 
differently with respect to this institution than any 
other. Indeed, it is my impression from interviews with 
former civil servants that visits to the AMI may have been 
slightly more frequent than to other institutions, 
possibly because of its pre-eminence, and also because 
Montreal was considered an agreeable place to visit I 
This, however, is a matter of impression only; what is 
clear is that there is no evidence to suggest that the AMI 
was either ignored, or deliberately made the subject of 


extra visits 


50 


It may be asked how Canada's research grant system 4, 

compared to that of other countries. Some scientists 
certainly held the view that Canadian granting agencies 
maintained much too close control of its grantees. Dr. 

Heinz Lehmann, an eminent psychiatrist and head of the As 

Verdun Protestant Hospital in Montreal (now known as the cc 

Douglas Hospital Centre), certainly thought so, as is he 

evident from the newspaper clipping at Appendix 32. Se 

at 

(6) Conclusions gr 

na 

In conclusion, it is my opinion that in relation to the co 

structure and operation of its granting procedures, the em 

Department of National Health and Welfare conducted itself wo 

at all times in a prudent and professional manner. The moi 

practice of careful internal review of all applications, qu« 

followed by a referral of the applications to two experts 
in the particular field from outside the Department for To 

detailed and anonymous scrutiny and comment, followed in coi 

turn by a review by the panel of qualified outside experts ext 

forming the Mental Health Advisory Committee and its fit 

Research Sub-Committee, in my opinion demonstrates the int 

good faith and competence of the public servants lat 

responsible. set 

(lc 


51 


4. THE CLIMATE OF THE TIMES 

A. The background to the National Health Grant System 

As far back as 1919, Prime Minister Mackenzie King had 
committed himself and his party to some form of national 
health program for Canada. However, not until after the 
Second World War did the idea of a national health program 
at last appear feasible. The government recognized that 
great improvements had to be made in the ability of the 
nation to deliver health care across the country before it 
could introduce such a program. There were simply not 
enough facilities or personnel to meet the demands that 
would arise upon the implementation of such a program, and 
moreover there were vast regional differences in the 
quality of health care. 

To remedy these deficiencies, the federal government 
conceived the idea of assisting the provinces in the 
extension and improvement of services in specific health 
fields, as a preliminary step towards the later 
introduction of, first, the hospital insurance plans, and 
later, national health insurance. In 1948, the government 
set up the National Health Grants in ten separate fields 
(later expanded to thirteen), including for example public 


52 


■ 


health, tuberculosis control, venereal disease, crippled 
children and cancer. One of these was the Mental Health 
Grant . 


A 1 


The purpose of the Mental Health Grant was to cover 
projects of three main types: 


(a) to provide services in the community, 

(b) to provide more adequate staff and equipment 
in the mental hospitals and in the 
psychiatric wards in general hospitals, and 

(c) to provide training for personnel needed in 
mental health work; this was considered to 
include psychiatric research. 


The 

B . Some Background Data 

Jan 

Hon 

When Prime Minister Mackenzie King announced the Mental 

at 

Health Grant in the House of Commons on May 14, 1948, he 

hea 

said: 

bot 


" Mental Health Care - Parliament will be asked to 
make provision for a similar grant to the provinces 
for similar purposes for mental health care 
amounting initially to $4 million per annum and 
rising over a period of years to a maximum of $7 
million per annum. The seriousness of the problem 
of mental illness can best be illustrated by 
reference to the fact that between one-third and 
one-half of all hospital beds in Canada today are 
occupied by patients suffering from mental illness . " 
(Emphasis added) 


tha 

inc 

ps> 

wor 


PS} 


bee 


53 


A few other figures from this era are of interests 


"Mental and nervous diseases account for more 
illness than cancer, infantile paralysis and 
tuberculosis combined. At any one time, one out of 
every 150 adults in the general population is 
hospitalized because of mental disease is the 
finding in areas where mental hospital facilities 
are most nearly adequate (Landis and Page, Mental 
Health, 1939)." 

"One person in 18 to 20 will spend some part of his 
lifetime in a mental hospital." 

"One person in 10 of the general population will be 
incapacitated by some variety of mental disease at 
some time during his life." 

"There are 50,000 patients in the mental hospitals 
of Canada. (DBS)" 


The foregoing information comes from a memorandum dated 
January 18, 1949 from departmental officials to the 
Honourable Paul Martin, Minister of Health (copy attached 
at Appendix 33). Grants for research came under the 
heading of "personnel needed in mental health work". The 
bottleneck in the expansion of mental health services at 
that time was lack of trained personnel. The goal was to 
increase considerably the number of psychiatrists, 
psychologists, social workers, nurses and community 
workers in the mental health area. 

t 

C. The state of psychiatry and the growth 
in research after 1948 


Psychiatry in the late 1940's and early 1950's was just 
beginning to emerge from the era of the "lunatic asylum". 


54 




There was great hope, almost a yearning, on the part of 
the medical profession, public servants and politicians 
that some means might be found, through new techniques 
such as electroshock therapy, insulin coma shock therapy, 
psychopharmacology, etc., by which we would cure the ill, 
and at the same time empty the hospitals of a substantial 
- and costly - proportion of patients. Mental illness was 
looked upon as one of the last great fields of human 
suffering to be conquered. Scientists had discovered 
spectacular new drugs such as sulfa and penicillin to cure 
the physically ill; was there nothing that could be done 
for the largest group of all, the mentally ill? 

Such were the thoughts of many with whom I spoke during 
the course of preparing this opinion. It is perhaps no 
wonder, then, that in conquering mental illness, a field 
in which so little had been done and so much was left to 
do, a great sense of urgency permeated the thinking of the 
times, and gave great impetus to find solutions, and as 
quickly as possible. And the key to the solution was: 
research . 

In a memorandum by Dr. Charles A. Roberts, M.D. , Chief of 
the Mental Health Division, dated April 8, 1953 (copy 
attached at Appendix 34), the following appears: 


And , 
Insu 
of t 
ref e 
than 
illn 
1953 

Dr. 

time 

deve 

loo* 

the 

deve 

thri 

prot 

prol 

keej 

att* 

witl 


res< 


55 


"When the National Health Grants Programme was 
initiated, it was recognized that there was a great 
need for research in the whole field of health ... At 
the time there was a little research being conducted 
by people in training and by the staff of Laval 
University, by the staff of the Department of 
Psychiatry at McGill University and at the Toronto 
Psychiatric Hospital. Beyond this, I am unaware of 
any mental health or psychiatric research being 
conducted in the country at that time. " (Emphasis 
added ) 


And, in a report of Dr. Roberts to the Director of Health 
Insurance Studies, dated August 20, 1953, on the subject 
of the estimates for the 1954-55 Mental Health Grant, 
reference is made to the fact that in 1947 little more 
than $25,000 was spent on research in the field of mental 
illness in Canada. In 1948, $4,850 was the figure. By 
1953, this had increased to $461,626. 


Dr. Cameron, the pre-eminent psychiatrist in Canada at the 
time, was frustrated with the slow pace of progress in 
developing new psychiatric procedures. He was always 
looking for a breakthrough; in this he was in tune with 
the sense of urgency that gripped this period in the 
development of psychiatry. He was in the vanguard of the 
thrust for research in an attempt to solve the outstanding 
problems of mental illness. And as an ambitious 
professional and an expert "grantsman", he was able to 
keep himself in the forefront. The newspaper article 
attached as Appendix 35 gives something of the intensity 
with which Cameron viewed the cause of psychiatric 


research 


56 


By the time of the eighth meeting of the Advisory 
Committee on Mental Health, held February 28 and March 1 , 
1955, Mental Health Research Grants from the Department 
had reached about $500,000, out of a total of approximate- 
ly $1.6 million for research in the whole health field. 

The mental health share was thus a substantial part of the 
total, and the trend did not change. By the end of the 
1962-63 fiscal year, a total of about $8 million had been 
spent on mental health research since 1948, out of a total 
of about $30 million for medical research in all fields. 

The tremendous growth in psychiatric research demonstrated 
by these figures is a clear indicator of how crucially 
important the public service and the politicians of the 
day regarded the problems of mental illness, and the sense 
of urgency with which they and the medical profession were 
determined to conquer the problem. This sense of urgency 
was emphatically confirmed to me by the Honourable Paul 
Martin, Minister of Health in the early years of the 
National Health Grants program. 

Finally, an impression of just how new the field of psy- 
chiatry was as a discipline of its own may be gained from 
the following starting dates for particular programs: Uni- 
versity of Edinburgh, 1912; London, 1921; Toronto, 1936; 
McGill, 1943; American Board of Psychiatric Examiners, 
1935; Royal College of Physicians and Surgeons - Psychia- 
tric qualification, 1944. 


57 


5. THE PERSONALITY, CHARACTER, AND PROFESSIONAL ACTIVITIES 
OF DR. D. EWEN CAMERON, AND AN ASSESSMENT OF THE 
QUALITY OF HIS WORK 

A. Personality, character and professional activities 

There is attached at Appendix 36 a series of extracts from 
private papers of Dr. Robert A. Cleghorn, a psychiatrist 
at the AMI from 1946 to 1970 (when he retired). In 1964, 
Dr. Cleghorn succeeded Dr. Cameron as head of the AMI. 

They were thus long-time associates. These extracts, 
given to me on a strictly confidential basis by Dr. 
Cleghorn, constitute the best source of direct information 
I have seen, both as to the character of Dr. Cameron him- 
self and as to the nature and quality of his professional 
work . 

i 

A number of other people I interviewed were acquainted 
with Cameron; and what follows reflects the views not 
only of Dr. Cleghorn, but of these other people as well. 
"Acquainted" is the right word, because it seems no one 
knew Dr. Cameron very well. He was an intensely shy and 
private man, in spite of his great organizational abili- 
ties and many public activities. For example, despite 
their long association, Cameron never called Dr. Cleghorn 
by his first name. The closest he ever got to intimacy 
was "Doc" - and then only on rare occasions. And Dr. 
Cleghorn was only once invited (socially) to Cameron's 
apartment in Montreal. (A U.S. citizen, Cameron's 


58 


permanent residence was located at Lake Placid, New York 
State, just across the Quebec border, and he apparently 
spent his weekends there.) Nor, it seems, were there 
others in the work place with whom Cameron allied himself 
closely. As Dr. Cleghorn points out, there was no "No. 2" 
at the AMI; and individual psychiatrists were free to 
pursue their own interests as they wished and on their 
own. 

Dr. Cameron was born in Scotland, the son of a Presby- 
terian Minister. It seems that the father was an authori- 
tarian figure, somewhat aloof from his son. A number of 
people I spoke to alluded to this family background as an 
explanation for a number of facets of Dr. Cameron's own 
personality; his driving ambition, his resentment of au- 
thority figures, his determination to prove himself and 
his ideas without reference to or intellectual guidance 
from the work of the great psychiatrists of the past - 
Freud, Jung, Adler, Meyer, etc. 

As a person, he was ruthless, determined, hard-driving, 
aggressive and domineering, with a strong and forceful 
personality. He was not a person that anyone would easily 
or readily stand up to. He was a person much admired, but 
seldom liked; in some senses, he was almost charismatic. 


59 


He was sometimes aloof from his patients and colleagues 
alike. He seemed not to have the ability to deeply 
empathize with their problems or their situations. 

It is easy to see how such a person could be regarded as 
the "mad scientist" of some media reports. 

However this may be, it is clear that Cameron at the AMI 
was an extremely ambitious, almost a driven, man. He was 
motivated by ambition for personal fame as a psychiatrist 
and as a builder of his profession. He wanted to create, 
and succeeded in creating, a leading centre for psychia- 
tric training and research. In personal terms, it would 
seem that he wanted nothing more than to break through the 
barriers to understanding mental illness that then existed 
and to make his mark as a world leader in research. 

He received extremely good training as a psychiatrist; 
see Appendix 5, p. 3 and Appendix 36, Part I, pp. 

109-110. In terms of his professional associations, he 
could not have done more. He was the President of the 
Canadian Psychiatric Association, the American Psychiatric 
Association (1953), and in 1963 became the founding 
President of the World Psychiatric Association, an 
organization largely formed through his own efforts. 


60 


He was the author of 104 papers and four books. His 
reputation in his profession may be gleaned from the 
retirement and obituary notices in professional journals 
(Appendix 36A). He died in 1967. 

He was motivated to help mankind in his chosen field of 
psychiatry. While not a warm man in the sense of having 
close personal associations, those who knew him conclude 
that there is no question as to his fundamental dedication 
to the improvement of mankind through medicine. 

He was a brilliant administrator and organizer. He took 
the AMI from a standing start in 1943 to the pinnacle of 
the huge success and reputation that it enjoyed in the 
late 1950's and early 1960's. He was a good teacher, 
dedicated to improving both the quality and number of 
mental health workers in Canada. When he took over at the 
AMI in 1943, the country was pitifully short of trained 
psychiatrists. By the time he retired in 1964, he had 
built up at McGill Canada's leading centre for the 
training of psychiatrists - in fact it was one of the 
largest in the world. Under him, more than 1,000 psychi- 
atrists were trained, and many of these went on to attain 
great eminence in the psychiatric profession across the 
country and around the world, in academic and admini- 
strative positions and in public and private practice. 

m 

Throughout his time there, the AMI was a beacon that 


61 


attracted to McGill from all over the world gifted 
students and outstanding professors representing a wide 
range of psychiatric opinion and practice. 

Dr. Cameron was a strong and early advocate of the "open 
door policy" in the treatment of the mentally ill, a 
policy that attempted to take psychiatry in the public 
mind out of the era of the asylum, in which "untreatable 
lunatics" were locked away more or less forever, into an 
era of treatment in which mental illness was to be looked 
upon as just another medical affliction. He regularly 
held "open houses" at the Allan, to which members of the 
general public were invited to see the work being done 
there. 

In general, there are two schools within the profession of 
psychiatry — the psychoanalytic school (Freud), and the 
"physical" school that believed mental illness could be 
explained and cured in physical terms. Cameron was firmly 
in the latter camp. He did not have a great deal of faith 
in psychoanalysis. Psychoanalytic procedures were very 
time-consuming; this was very costly and, more important, 
meant that the patient suffered longer while waiting to be 
cured. Cameron's procedures, based on the "physical" 
approach, were designed to ease the suffering of patients 
in a shorter time. Cameron's methods did not work. 
Psychiatry is still searching for methods that will. 


62 


However, the fact that in the years since 1964 the 
physical approach has fallen somewhat out of fashion in 
favour of the analytical approach, makes it more difficult 
for psychiatrists and others to look at the problem 
through 1950's and 1960's eyes (as we must in passing 
judgment both legal and ethical) rather than through the 
eyes of the 1980's. 

Finally, some background on the relationship among McGill 
University, the Royal Victoria Hospital ( RVH ) and the 
Allan Memorial Institute (AMI) would be helpful. McGill 
and the RVH are separate legal entities. However, the RVH 
is associated with McGill in that it is a teaching 
hospital of the McGill University's Medical Faculty (one 
of five such hospitals), and people on the hospital's 
staff hold cross appointments at McGill. The AMI is the 
psychiatric wing of the RVH and here again, the staff hold 
cross appointments. 

Thus, Dr. Cameron held an appointment as Professor and 
Chairman of the Department of Psychiatry in the Faculty of 
Medicine at McGill University. He was also Chief of 
Psychiatry at the RVH, and at the same time Director of 
the AMI. He received a salary from McGill; in addition he 
obtained income from private patients. However, since the 
AMI was the psychiatric wing of the RVH, in medical 
matters he was responsible to the RVH. 


63 


B. An assessment of Cameron's abilities as a 
research scientist 


(1) General conclusion 

Dr. Cameron was not a good scientist. By this I mean, 
skilled as he might have been in medicine in general and 
in psychiatry in particular, he was not a sound practi- 
tioner of the art or skill of scientific research. Like 
many medical doctors of the day, especially psychiatrists, 
he did not have a good understanding of basic scientific 
methods. He would not plan his research in a proper 
scientific way, with clear goals in mind, with proper con- 
trols against which the results of his work could be mea- 
sured, and with sufficient follow-up after the procedures 
had been completed to see whether the results held up over 
time. Like many medical doctors, his analysis of the 
efficacy of a particular treatment would sometimes not go 
much further than the observation that "the patient seems 
better today". Dr. J.W. Fisher, a research scientist with 
a Ph.D. in virology, in about 1952 wrote a draft critique 
(undated) on this subject while he was employed as an 
officer in the Mental Health Division. In it, he examined 
all of the Mental Health Research Grant applications and 
progress reports, listing their defects from the point of 
view of scientific methodology. The critique is attached 
at Appendix 37; for present purposes, perhaps his most 
important point, found at the end of his summary, is this: 


64 


"In making these statements I wish to make it 
clear that in no instance is the integrity of 
the grantee and his associates questioned, nor 
is it implied that good research work was not 
done in experiments well designed to provide 
data, which on an appropriate analysis, would 
provide unambiguous answers to the questions the 
experimenters wished to answer. Rather, these 
conclusions arrived at only indicate that the 
majority of the grantees failed, for some reason 
or another, to provide evidence supporting the 
excellence of their work. Regarding all this I 
think of the words of Louis Pasteur, 'In 
experimental science it is always a mistake not 
to doubt when facts do not compel you to 
affirm. ' " 


(2) The Hawthorne and placebo effects 


A major shortcoming in Dr. Cameron's methodology was his 
failure to allow for the so-called "Hawthorne effect", 
and/or the "placebo effect". 


A hospital staff trying out a new procedure will often ex- 
pend much more time and effort with the patient than in 
the case of routine treatments. Often there is an air of 
expectancy, even excitement. Patients do indeed appear to 
get better, but this is often due to the extra attention 
being paid to them, rather than to the treatment. 
Similarly, if told a new drug will help, one finds that 
the patient does in fact improve - even if the "drug" ad- 
ministered is a neutral substance (placebo). Similar 
effects are noted in other fields. A new method of per- 
sonnel management is introduced at the office; productivi- 
ty picks up; after a while, the "new" procedure becomes 


65 


routine and productivity goes back to normal. These 
"Hawthorne" and "placebo" effects are well known today, 
and they operate with particular force in the case of men- 
tally ill patients, due to the nature of the illness. 
Modern scientific research is carried out in such a way as 
to eliminate them, through "double blind" techniques 
(where neither the patient nor the person administering 
the "drug" knows whether it is a placebo or not) and other 
methods . 

Cameron failed to allow for these effects in his research 
and treatment, and he failed to discount them in assessing 
results. Depatterning and psychic driving involved tre- 
mendous efforts on the part of many professionals, bring- 
ing patients into intimate contact with staff over many 
months, even years, as is shown by the underlined portion 
of the quotation from one of Cameron's articles, set out 
in section 2.E. of this opinion. 

Cameron's patients did indeed "seem to be getting better", 
but this may well have been due to the operation of these 
effects, not Cameron's treatments. 

The fact that the Hawthorne effect was likely at work in 
Cameron's research became apparent with the results of the 
study on depatterning ordered by Dr. Cleghorn when he 
replaced Cameron as head of the Allan in 1964 (See 


66 


Appendix 38). In brief, the study shows that, in general, 
patients who had received depatterning were no better off 
than those who had not, after a few months or years (i.e. 
after the Hawthorne effect had worn off). It was on the 
basis of this study that Dr. Cleghorn stopped the 
depatterning procedure at the Allan. 

Should Dr. Cameron have taken the Hawthorne and placebo 
effects into account in performing his research and 
treatments? A really first class scientist probably would 
have. That is why I have said in section 2.H. of this 
opinion that depatterning "was not justifiable even by the 
standards of the time and even in the light of the rather 
rudimentary level of scientific and medical knowledge of 
those days compared to today." 


On the other hand, as Dr. Cleghorn says (Appendix 36, Part 
II, pp. 37-38) these effects had not reached common notice 
until the 1950's, and: 


"It was the 20 to 25 year period from 1935 [i.e. 

1955 to 1960] before the concept of adequate 
controls [such as making allowance for the Hawthorne 
and placebo effects] had assumed a regular place in 
medical research, and longer for psychiatry, for it 
had less involvement than medicine in the basic 
sciences, therefore was even more laggardly. 11 ' 
(emphasis added) 


67 


If Cameron was at fault for not taking these effects into 
account during research and treatment, and for not doing 
long-term follow-up studies on his patients to determine 
whether it was the treatment or something else that seemed 
to make them better, then he was in the company of many 
others. For example, as Dr. Cleghorn points out (Appendix 
36, Part II, p. 37), it was not until twenty years after 
insulin shock therapy treatment came into effect in the 
1930's that psychiatrists realized the treatment had no 
value for a large range of patients; patients just felt 
better because of the attention paid to them. Neverthe- 
less the treatment, equally as intrusive as massive elec- 
troshock and if anything more dangerous, was still in use 
in Canada until well into the 1960's. Medicine and psy- 
chiatry provide many other examples of this failure to 
take these effects into account in the 1950 's and early 
1960 's when the necessity for proper scientific controls 
was not as widely understood by the medical profession, 
particularly psychiatry, as it is today. 

It is for this reason that in section 2.H. of this opinion 
I qualified the conclusion there stated (and restated 
three paragraphs above) with the statement that this con- 
clusion is only apparent with the benefit of hindsight. 


68 


(3) The background for the general conclusion on 

Dr. Cameron's abilities as a research scientist 

The state of affairs discussed in the last subsection has 
changed in the 1970's and 1980 's, but Dr. Cameron's 
deficiencies in this regard were typical of the medical 
profession, especially psychiatry, in those days. (See 
the reports of Dr. MacDonald, Appendix 5, pp. 2-3 and 6; 
and Dr. Lowy, Appendix 6, p. 6.) 

Cameron was therefore not at all unique in being deficient 
in scientific method and the techniques of scientific 
research. Research in medical fields did not really get 
underway until the 1930 's and it was twenty or thirty 
years before they came to be fully accepted (see the views 
of Dr. Cleghorn in Appendix 36, Part I, p. Ill and Part II, 
p.27 and p.37). In fact an examination of research by 
other psychiatrists active at the time shows that the 
scientific quality of Cameron's work, though poor, was "no 
less rigorous" than, or at least "not significantly worse 
than", those of his contemporaries in psychiatric 
research: See Dr. Lowy, Appendix 6, p.6, and Dr. 

MacDonald, Appendix 5, p.6. As further evidence of this 
there is the fact that his work was widely published in 
peer-reviewed scientific and medical journals. Moreover 
in Dr. Fisher's detailed assessment of the scientific 
quality of research programs that had been carried out to 
that date in mental health (Appendix 37), Dr. Cameron's 


69 


projects, though not free of deficiencies, come off well 
in comparison. 

If, therefore, Cameron's research work in the field of 
massive electroshock therapy and psychic driving left a 
great deal to be desired from the scientific point of 
view, as it undoubtedly did, this failing does not in 
itself show that the work in question was deliberately 
aimed at some purpose other than the benefit of the 
patient. As explained, the view of the doctors I inter- 
viewed and of the three experts I engaged is that the 
benefit of the patient was indeed Cameron's true aim, a 
fact which they believe is demonstrated by Cameron's 
professional writing (Appendices 7 to 17). 

(4) Reservations of psychologists 

It is right to note here that some of the psychologists 
whom I interviewed hold a more sceptical view of Cameron 
than do the medical doctors. Also, as noted earlier. Dr. 
Donald 0. Hebb was also sceptical of Dr. Cameron's methods 
and scientific abilities. Being schooled in a related 
field, and having the added advantage of training and 
experience in scientific method and in research, this 
attitude is perhaps natural. 


70 


What is noteworthy, however, is that, like the medical 
doctors, none of the psychologists spoke up in opposition 
to Dr. Cameron at the time when the work was being done. 

My conclusion is that it is only with the special know- 
ledge that comes with an understanding of scientific me- 
thods and proper procedures for scientific research, and 
in some cases with the benefit of hindsight and perhaps in 
the light of the allegations made by the nine plaintiffs 
in the U.S.A., that these psychologists now find them- 
selves more strongly critical of Cameron than the medical 
people . 

C. Conclusions on the quality of Dr. Cameron's work and 
its place in the context of the times 

After interviewing thirty-one people now or formerly ac- 
tive in the field of mental health research, and with the 
benefit of the opinions of three independent experts, the 
conclusion on all of this material that comes closest to 
the real truth, in my opinion, is that Cameron was a good 
man in the sense that he was trying to do the best he 
could for his patients, a good doctor in the sense that he 
understood his medical speciality well enough to practice 
it, but that the poor quality of his scientific research 
led him into serious error. What is clear is that, while 
there were private doubts about the efficacy of psychic 
driving and depatterning , the details of which are dis- 
cussed fully at the end of this section, no one raised 


71 


these doubts at the time in such a way as to suggest that 
these treatments were improper. In particular, no one - 
whether a psychiatrist, psychologist or in another field 
- associated with the Mental Health Division of the 
Department of National Health and Welfare, or with any of 
its external research advisory committees, had doubts 
strong enough to suggest that grants ought not to be made 
to Dr. Cameron because of the nature or quality of the 
work he was carrying out. 

It is also relevant to note that this is not a case of 
"experiments" carried out on socially disadvantaged 
patients who were under compulsion or did not know any 
better. Cameron's was a "carriage trade" practice; his 
patients were for the most part voluntary, having been 
referred to him by other doctors in private practice, both 
general practitioners and other psychiatrists, in the 
belief that he was a leading psychiatrist of the day. 

It was Cameron's practice to send regular written reports 
to the referring doctors, explaining his procedures in 
detail . 

These facts constitute strong evidence of the high regard 
in which he was held, and of the views of the medical 
community generally as to the efficacy and propriety of 


his treatments 


72 


■ 


In this connection, two points might be noted. First of 
all, while no depatterning and psychic driving treatments 
of this nature are carried out today and indeed almost 
certainly could not be, given today's much stricter 
standards of research and treatment, nevertheless some 
psychiatrists believe that some patients were indeed 
helped by these procedures. Included among these are Dr. 
Cleghorn himself, who knows of at least some patients who 
in his opinion did in fact benefit, and knows personally 
of no patient of whom it could be said with certainty that 
they were worse off because of the depatterning procedures 
than they otherwise would have been. Dr. Charles A. 
Roberts also feels the same way. Almost all doctors - 
including certainly Drs. Cleghorn and Roberts - would 
however agree that these procedures were false trails in 
the field of psychiatric research and treatment, and that 
on balance the treatments were of no benefit. Certainly 
there is no suggestion on anyone's part that the 
techniques should be revived today, given all the new 
techniques and procedures (especially psychopharmacology) 
now available to the profession. 

It should be further noted that much more intrusive and 
intensive psychiatric procedures were readily accepted in 
the 1940's, 1950's and early 1960's than would be accepted 
today. For example, electro convulsive therapy was 
applied in the early days without the benefit of muscle 


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73 


relaxants, such as chlorpromoz ine , curare, etc. These 
treatments often resulted in the patient undergoing ex- 
tremely violent muscular spasms; some patients even broke 
their backs. In those days too, the surgical procedures 
of lobotomy and leucotomy were developed and in widespread 
use. These involved nothing less than the surgical de- 
struction of certain parts of the brain, which did indeed 
succeed in relieving the patient's adverse mental condi- 
tion, but at the same time destroyed the person's feelings 
and whole personality. The technique of insulin coma shock 
therapy was also highly intrusive and at least as danger- 
ous as massive electroshock treatments. And some of the 
newer experimental drugs, such as LSD-25, were also highly 
intrusive because of their incredible power to alter the 
state of the mind. In the authoritative textbook, 
Kalinowsky and Hoch, 2d ed. (1957), massive electroshock 
therapy is treated without adverse comment (See Appendix 
38A). None of these procedures are used now, nor would 
psychiatrists today recommend that they be reintroduced. 

The fact is that massive electroshock therapy and psychic 
driving did not appear as out of place in the 1950's and 
early 1960's as it does today. While certainly not regard- 
ed as benign, these procedures were nevertheless not re- 
garded as lying outside the realm of the acceptable, in- 
volving as they did intrusions of the same order of magni- 
tude as those associated with other psychiatric techniques 


74 


of the day. And indeed, given the state of psychiatric 
knowledge at the time, and given the overwhelming problems 
with which psychiatrists were faced - hundreds of 
thousands of severely ill mental patients and few tools 
with which to relieve their agony and distress - many 
people I interviewed felt the medical profession was right 
to try new techniques. It is no argument against Dr. 
Cameron's procedures, any more than it is against many 
other equally intrusive techniques, to say that today - 
with our much more sophisticated understanding of the 
workings of the mind and our much broader range of treat- 
ments - they appear to be barbaric. 

D. Knowledge held by H&W employees as to the 
quality of Dr. Cameron's research 

None of the public servants to whom I spoke recall ever 
having heard any adverse views expressed, either from 
within Departments of government or by external reviewers 
or by outside research advisory panels, as to the proce- 
dures or techniques being utilized by Dr. Cameron and the 
AMI. If at the time of a grant application they had heard 
"mutterings" , the practice would have been to discuss them 
and make an evaluation as to whether the research project 
in question had sufficient scientific and medical merit to 
warrant its being funded by agencies of government. 




75 


It is true that in those days public servants and members 
of the advisory panels did not consider it to be their 
responsibility to be much concerned about the ethics of 
the proposed research, or about the quality of the consent 
that had been obtained from the patients and/or volun- 
teers. Compared to the attitude of today, responsibility 
rested much more on the doctor or scientist carrying out 
the research, and much less on either the institute to 
which he was attached or on the granting agency; it was 
simply assumed that ethical people did ethical things. 

(This point is discussed in greater detail in Section 6). 
Nevertheless, the persons to whom I spoke all suggested 
that, had there been concern that the research project was 
improper or unethical, and not for the therapeutic benefit 
of the patient, the matter would certainly have been 
raised either internally, by the external reviewers, or by 
the outside research advisory panels. 

E . Conclusion on the efficacy and propriety 
of: Dr. Cameron *s research, and contemporary 
reservations 


The evidence contained in the file materials, the evidence 
of the people I have interviewed and particularly the 
opinions of the three experts, all point to the conclusion 
that the work done by Dr. Cameron and his associates, 
though today regarded by most medical and scientific 
people as unsound, was not carried out for any improper 
purpose, but was intended by Dr. Cameron and his 


76 


associates to be of therapeutic benefit to his patients. 
This does not, of course, dispose of the ethical question, 
which is discussed in the next section of this report. 

Nor is this conclusion free from controversy. 

There were a number of psychiatrists and other medical 
doctors with whom I spoke who either had doubts themselves 
at the time as to the propriety (and indeed the efficacy) 
of Dr. Cameron's work, or who heard expressions of doubt 
on the part of others. There were others who at the time 
had no such doubts, and also some who had formed no 
opinion. The three experts I engaged have each concluded 
that Cameron's procedures were acceptable given the 
knowledge and climate of the times, and none of the other 
psychiatrists or medical doctors I spoke to expressed a 
contrary view. I concur with this conclusion. I have 
thought it desirable, for the sake of completeness, to 
list all comments I have heard (even casual comments from 
those who support this conclusion) that might be taken to 
be adverse to it. These comments are as follows: 

(1) Dr, Omond Solandt - Dr. Solandt, as chairman of 
the Defence Research Board, had a close 
colleague whose wife became a patient of Cameron 
and underwent the depatterning procedure. After 
a year, Cameron simply sent her back home and 
advised in a rather peremptory way that he could 


77 


do no more for her. Dr. Solandt and his 
colleague inferred from Cameron's report that he 
had depatterned the patient and was not able to 
repattern her. Dr. Solandt became sceptical of 
the efficacy of Dr. Cameron's methods and indeed 
formed the opinion that he was not possessed of 
the necessary sense of humanity to be regarded 
as a good doctor. He let it be known quietly, 
through Dr. W.N. Morton (now deceased), the 
Director of the Biological Research Division at 
the DRB , that he (Solandt) would not look 
favourably on any application that might be made 
by Dr. Cameron to the DRB for research in the 
psychiatric field. (The AMI did apply for, and 
received, grants from the DRB and these are 
discussed in section 3 of this opinion; but 
these grants were not for work in the field of 
psychiatric research.) 

It is speculated that Dr. Morton may have passed 
the message on to Cameron, probably in an inno- 
cuous way by suggesting to him that there would 
not be much point in making grant applications 
to the DRB because the DRB was not interested in 
carrying on work within Dr. Cameron's field. 


78 


Dr. Solandt did not take this matter any 
further, for example, by taking official action, 
because he was not a psychiatrist, and because 
his one exposure to Cameron's procedures was of 
a private and personal, not of an objective and 
scientific, kind. 

Although Dr. Solandt is not a psychiatrist, he 
is clearly one of Canada's most gifted 
scientific and medical research administrators. 
For this reason, I consider his contemporaneous 
reservation about the efficacy and propriety of 
Dr. Cameron's treatments to warrant very close 
consideration. Nevertheless, I do not consider 
Dr. Solandt's reservation to be of sufficient 
force to change my conclusions as to the legal 
or ethical responsibility of the Government of 
Canada. While it turns out that his instincts 
about the efficacy of Dr. Cameron's techniques 
were quite right, his was not a scientific but 
an intuitive and personal judgment based on one 
failure (as he saw it) of the depatterning 
technique. Cameron himself appears to acknow- 
ledge that in some cases the depatterning 
procedure was not successful; see (for example) 
pages 69-70 of the article attached as Appendix 
15 and Dr. Cleghorn's papers, Appendix 36, Part 


79 


II, p.31. In my opinion, the casual and non- 
scientific observation of the failure of one - 
or many - patients to be improved as the result 
of a medical procedure is not sufficient ground 
on which to base a conclusion, however correct 
it may prove in retrospect and however eminent 
the observer, that Cameron’s procedures were 
improper when judged by the standards of the 
day. Dr. Solandt agrees with this view. 

(2) Dr. Robert A. Cleghorn - It is noteworthy that 
Dr. Cleghorn was doubtful, as many others were 
at the time, of the efficacy of the procedures. 
Cameron himself set up a committee in the early 
1960's under Dr. Cleghorn to see what might be 
done to curb the excesses of one particular 
member of the AMI staff, whose practice was to 
use massive electroshock therapy in an almost 
indiscriminate way. The offender's appointment 
at the Allan was eventually terminated. And in 
1964, as noted previously. Dr. Cleghorn himself, 
upon succeeding Cameron as Director of the AMI, 
set up his own committee to examine the depat- 
terning treatment. The committee concluded on 
analysis of the procedures that had been 
followed and on examination of a large number of 


80 


patients who had received the treatment, that it 
had not been efficacious. To quote them 
(Appendix 38): 


"Results of our follow-up investigation 
indicate that, in terms of both recovery 
rate and current clinical condition, 
patients who received intensive electro 
convulsive shock therapy cannot be dis- 
tinguished from those who receive other 
forms of treatment. . .The incidence of 
physical complications and the anxiety 
generated in the patient because of real or 
imagined memory difficulty argue against the 
administration of intensive electro consul- 
sive shock as a standard therapeutic 
procedure. " 


As a result of this study. Dr. Cleghorn put a 
stop to the use of the procedure at the Allan 
Memorial Institute. 


Dr. Cleghorn in his private papers describes the 
treatment as "therapy gone wild with scant 
criteria"; (Appendix 36, Part II p.88); but in 
my discussions with him he gave me to understand 
that in this passage he was addressing the 
general effect of the treatments on patients as 
judged with the benefit of hindsight, not 
Cameron's purpose or attitude or mind in 
carrying them out. As is obvious from his 
private papers. Dr. Cleghorn writes with con- 
siderable style and flair. On reflection, he 
feels the colourful phrase quoted above is an 


81 


overstatement and, as his private papers read as 
a whole (as well as his discussions with me) 
make clear, at no time, then or now, did he hold 
the view that Cameron's work was either scienti- 
fically or ethically improper, given the 
standards of the day. In fact, he concludes 
that Cameron's intentions were to benefit his 
patients, and indeed believes that some of them 
may in fact have benefitted from the treatments. 

Finally, in 1966 at an international psychiatric 
conference. Dr. Cleghorn bumped into Dr. 

Cameron, who asked about the status of the 
depatterning procedures. When Cleghorn told him 
that he had stopped them, Cameron replied, "I 
thought you would." 

In conclusion, it is clear to me from dis- 
cussions with Dr. Cleghorn and from his private 
papers that in his view Cameron's work was 
representative of a legitimate area of inquiry 
given what was known at the time, but that when 
more information became available as a result of 
the follow-up study set up by Dr. Cleghorn when 
he became head of the Allan (Appendix 38), it 


82 


became apparent that Cameron's procedures were 
not efficacious, and Cleghorn therefore stopped 
them . 


(3) Dr. F.C. Rhodes Chalke - Dr. Chalke, a psychi- 
atrist, former employee of the Defence Research 
Board, lecturer at the AMI and later President 
of the Canadian Psychiatric Association, had 
some doubts at the time. He was asked, by the 
family, to take as a patient the widow of a 
former medical colleague, after she had been 
unsuccessfully given the depatterning treatment 
by Dr. Cameron. It was Dr. Chalke' s job to 
attempt to treat her for severe depression. It 
was this particular experience that gave rise to 
doubts on his part. Nevertheless Chalke, too, 
did not raise these doubts publicly; parti- 
cularly in light of doctor/patient confident- 
iality. 

(4) Dr. Charles A. Roberts - Dr. Roberts was from 
1951 until 1957 the head of the Mental Health 
Division of the Department of Health and 
Welfare. He had some private doubts at the 
time, but like others refrained from expressing 
them in view of Dr. Cameron's pre-eminence in 
the psychiatric profession in Canada. 


83 


(5) Mr. John Osborne - Mr. Osborne, a former H&W 

economist with no medical or scientific 
training, remembers attending a meeting, perhaps 
of the Dominion Council of Health, sometime in 
the 1950's. While walking down the aisle of the 
meeting room, he overheard Dr. G.D.W. Cameron 
(now deceased) , the then Deputy Minister of 
National Health and Welfare, saying to either 
Dr. Charles Roberts or Dr. Ken Charron (Mr. 
Osborne cannot remember which) that he thought 
that Dr. Ewen Cameron of the AMI was going too 
far. This was just a snatch of conversation 
and was never pursued by Mr. Osborne. Neither 
Dr. Roberts nor Dr. Charron remember the 
conversation. . 

(6 ) Dr. Craig Mooney and Dr. J.W. Fisher 

These persons expressed keen reservations to me 
about the adequacy of Cameron's work. Dr. 

Mooney is a psychologist, and Dr. Fisher a 
virologist. Dr. Mooney was at different times 
secretary of the Subcommittee on Research of the 
Mental Health Advisory Committee of the Mental 
Health Division, H&W, and was head of the 
personnel research section of the Human 
Resources Section of the Defence Research 


Board . 


84 


Dr. Fisher, as a research officer with the 
Mental Health Division from about 1950 to 
1956/57, personally reviewed all applications 
for Mental Health Grants received by the 
Division in that period. Their reservations had 
to do with the lack of scientific rigor with 
which the research work was carried out. A more 
detailed discussion of Dr. Fisher's views 
appears elsewhere in this opinion. To repeat, 
the basic point is that in the 1950's and early 
1960's medical researchers generally and psychi- 
atrists in particular did not have a good grasp 
of scientific research methods, in contrast to 
psychologists and others with scientific 
training . 

In my interview with Dr. Fisher, he considered 
the period in question (the 1950's) to be the 
"age of clinical experimentation" where new 
therapies were being tried quite freely and 
frequently. He gave the example of 
tranquilizers. Certainly his written assess- 
ments at the time do not suggest Cameron's work 
was any more inadequate scientifically than that 
of other researchers. 


85 


(7) Sir Aubrey Lewis - Lewis and Cameron both took 
their residencies in psychiatry at Johns Hopkins 
University in 1926 under Dr. Adolf Meyer. Their 
relationship, personally somewhat strained, is 
described in Dr. Cleghorn's notes in Appendix 
36, Part II, pages 85-87. In 1957, when Lewis 
was head of the famous Maudsley Hospital in 
London, he told Dr. Cleghorn privately that he 
thought Cameron's depatterning treatments were 
"barbaric"; but on the other hand Cameron was 
invited to the Maudsley as a special guest 
lecturer in 1962 while Lewis was still in 
charge, an invitation that would be out of the 
question if there were any contemporary doubt in 
the mind of Lewis or that of the profession 
generally as to Cameron's scientific and medical 
competence or ethical standards. 

The foregoing comments, together with those referred to in 
the expert reports of Drs. Grunberg, McDonald and Lowy, 
(Appendices 4,5 and 6 respectively) constitute all of the 
comments I have heard or read which might be taken to 
point to a conclusion opposite to that which I have 
reached (namely that Cameron's research work was not 
improper given the practices, the standards, the level of 
knowledge and the climate of the time in which it was 


■ 


- 86 - 


carried out) . It is noteworthy that the general thrust of 
these doubts had to do more with the efficacy of Cameron's 
treatments than with their ethical quality. 

It will be appreciated that the conclusion I have reached 
cannot be stated in absolute terms. While all the medical 
people I spoke to, including the three experts, agree with 
it, some psychiatrists would probably disagree. My con- 
clusion to this question, the penultimate one I have had 
to address, is therefore not free from controversy. The 
answer to the ultimate question - whether the Crown is 
responsible legally or morally - is in my opinion much 
less free of controversy. This question is taken up in 
sections 9 and 10 of this opinion. 


6. ETHICAL CONSIDERATIONS SURROUNDING THE NATURE AND 
QUALITY OF DR. CAMERON'S ACTIVITIES, AND THE ISSUE 
OF PATIENT CONSENT 

In developing this section of my opinion I have relied 
heavily on the opinions of Drs. Grunberg, McDonald and 
Lowy, attached as Appendices 4, 5 and 6 respectively. 

A. Ethical standards in medical research and 
experimentation 

We start with this, that some form of "experimentation" is 
essential if any progress is to be made in medicine. To 
quote from THE DECLARATION OF HELSINKI AS REVISED (1975), 


"Reco 

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87 


"Recommendations Guiding Medical Doctors in Biomedical 
Research Involving Human Subjects": 

"Medical progress is based on research which 
ultimately must rest in part on experimentation 
involving human subjects." 

"In the field of biomedical research a fundamental 
distinction must be recognized between medical 
research in which the aim is essentially diagnostic 
or therapeutic for a patient, and medical research, 
the essential object of which is purely scientific 
and without direct diagnostic or therapeutic value 
to the person subjected to the research." 

The Helsinki Declaration was adopted by the World Medical 
Association in 1964 and revised in 1975; the Working Group 
on Human Experimentation from the Medical Research Council 
of Canada has described it as the most important of many 
attempts to provide standards in biomedical research, and 
cvpvresents as no other document the consensus of the world 
tomunity: see page 9 of Report No. 6, "Ethics in Human 
Experimentation", published 1978, attached as Appendix 39; 
the Helsinki Declaration is Appendix C-2 to this Report. 

The question is, of course, what are the legal and ethical 
limitations on such work? 

Society's ideas on this important subject have changed 
considerably in recent years. They have changed in general 
terms and they have also changed in specific terms. As 
for the latter, the specific requirements imposed on medi- 
cal researchers today to ensure that their work meets 
ethical standards are spelled out in much more detail now 


88 


than they were in the 1950's and early 1960's. Certainly 
scientists and medical doctors have never been ethically 
or legally permitted to conduct pure experiments on 
humans, in the sense of carrying out procedures on un- 
willing and unwitting victims for a purpose not intended 
to be beneficial to the patient, but rather for some other 
purpose such as the advancement of science, or to increase 
medical knowledge generally. However, until recent times, 
and certainly in the 1950's and early 1960's, much greater 
reliance was placed on the integrity of the person con- 
ducting the research than today. The major burden of de- 
ciding the ethical questions was placed squarely in the 
hands of the individual responsible investigator. To 
quote Drs. Lowy (Appendix 6, p.10) and Grunberg (Appendix 
4, pp.9-10) there was an attitude of "benign paternalism" 
towards the investigator. 

To be sure, the institution (in this case, the AMI) and 
the granting agency (in this case the Department of 
National Health & Welfare) always bore some measure of re- 
sponsibility, as both Dr. Lowy and the MRC Report make 
clear. But this responsibility was vaguely defined at 
best until at least the late 1960's and 1970's. 

In 1978, after considerable debate within the profession, 
the Medical Research Council of Canada produced the 
guidelines set out in Appendix 39. Thereafter, those 


engaged 
applied 
these gi 
for res< 

The res* 

and the 

today. 

viewed 

the Roy 

that th 

due to 

logy. 

ethics 

cal doc 

tees of 

active. 

absolui 

search* 

questi 

days n 

attach 

the in 

within 

exterr 

raise 

have 


89 


engaged in medical research of an experimental kind who 
applied for grants from the MRC were obliged to follow 
these guidelines. They are now standard in Canada, even 
for research in which the MRC is not the granting agency. 

The research that Dr. Cameron carried out in the 1950's 
and the 1960's could almost certainly not be carried out 
today. His research project would first have to be re- 
viewed by the scientific review committee of the AMI (or 
the Royal Victoria Hospital), and it is highly unlikely 
that they would approve his research on scientific grounds 
due to its weak theoretical basis and inadequate methodo- 
logy. Then, the project would have to go before the 
ethics committee, a committee usually consisting of medi- 
cal doctors, research scientists and lay people. Commit- 
tees of these kinds did not exist when Dr. Cameron was 
active. Their existence today, though not providing 
absolute guarantees, makes it much less likely that a re- 
searcher could carry out scientifically weak or ethically 
questionable research. This is especially so since nowa- 
days not only does the MRC require the researcher to 
attach to the grant application an ethics certificate from 
the institution's ethics committee, but also officials 
within the civil service who review the application, the 
external reviewers and the research advisory panels are to 
raise any concerns of an ethical nature that they might 
have in regard to the proposed research. While this was 


90 


also true in the 1950's and early 1960's, the custom then 
was to place much greater reliance on the integrity and 
competence of the investigator. Only in a clear case 
would the external reviewers be expected to raise ethical 
concerns. And, as detailed in section 5, I have uncovered 
no evidence to suggest that such concerns existed or were 
brought to the attention of the granting agency in 
relation to Dr. Cameron's research. 

The difference in approach between Cameron's time and our 
own may be discerned by examining the current MRC grant 
application form and ethics certificate at Appendix 40 and 
comparing it to the actual application signed by Dr. 
Cameron in the Mental Health Grant Project No. 604-5-433 
at Appendix 41. Neither the latter application nor the 
then current departmental memoranda on research grants, 
found at Appendix 26, refer to the question of ethics. 

B. The question of consent 

I turn now to the question of consent. The practice in 
the 1950's and early 1960's was to obtain a form of 
general consent. From the Orlikow and Morrow cases, we 
have examples of the kinds of consent actually obtained by 
the AMI. These consents, together with those for two 
other plaintiffs in the U.S. law suit (Mrs. Zimmerman and 
Mr. Weinstein), are attached at Appendix 42. See also 
Appendix 1A, p.14. 


91 


The fact is, general consents of this kind were regarded 
by all in those days as ethically adequate, and in 
addition they were sufficient in law to shield the doctor 
and the institution from legal liability. 

Today the situation has been substantially altered. This 
is due to the adoption since those days of the doctrine of 
"informed consent", under which in experimental proceed- 
ings or novel therapies the patient must be given a full 
explanation of what is going to happen, the likely side 
effects, alternative treatments available if any, the 
consequences of not taking the treatment etc. (Here it 
should be noted that while Dr. Cameron's procedures were 
initially experimental or at least in the nature of thera- 
peutic research, he later looked upon them as routine. It 
should also be noted that neither in the- 1950's and early 
1960 's, nor today, do granting agencies concern themselves 
with the question of consents from individual patients. 

It is simply assumed that such consents will be obtained.) 


C. Some developments subsequent to Dr. Cameron's tenure 
at the Allan in the matters of consent and choice of 
treatment 


The following developments will highlight the changes that 
have occurred since Dr. Cameron's time: 


92 


(1) The Halushka Case : This case, cited as Halushka 

v. University of Saskatchewan et al. (1965), 53 
D.L.R. (2d) 436, (Sask. C.A.) established 
clearly the doctrine of informed consent in 
medical experiments. The doctrine has since 
been elaborated and extended. 

(2) The "Patient's Rights" movement : This movement 

began in the mid 1960's in the U.S., as is 
evident from the September 1985 article attached 
as Appendix 43, taken from "Canada's Mental 
Health", a journal published by Health and 
Welfare Canada. The article gives the history 
of the Patient's Rights and Ethics Committee at 
the Douglas Hospital Centre in Montreal 
(formerly the Verdun Protestant Hospital). The 
Committee began in 1966 in response to a new 
development from the U.S.: the requirement of 
the U.S. Department of Health, Education and 
Welfare that any institution seeking research 
grants from the U.S. government needed to have 
an ethics committee review the research protocol 
before they could qualify. See also Schwartz, 
"Institutional Review of Medical Research" 
(1983), J. Legal Med. 143. 


93 


(3) The Helsinki Declaration , found at page 61 of 
Appendix 39, came out first in 1964. The Nurem- 
burg Code of Ethics in Medical Research (on 
which Dr. Cameron worked), a result of the post- 
war Nuremburg Trials, was found inadequate to 
meet the changing views of society on control 
over biomedical research. Hence the 1964 
Declaration. 

(4) Dr. Edmund Pellegrino , Professor of Medicine and 
Medical Humanities at Georgetown University, 
Washington, D.C., and Director of the Kennedy 
Institute of Ethics at the same University, is a 
recognized expert in the field of medical 
ethics. In his Killam Memorial Lecture at 
Dalhousie University on October 24, 1985, Dr. 
Pellegrino said that until 20 to 25 years ago 
(i.e. between 1960 and 1965), during the 2,500 
year history of medical ethics, the decision as 
to choice of treatment was made by the physician 
alone. The physician was the final authority 
both technically and morally, and his decision 
was not questioned. 


94 


(5) Thalidomide : The thalidomide disaster of the 

early 1960's opened the eyes of both the public 
and the medical profession to the tremendous 
dangers that new drugs (and by extension, other 
treatments) could pose if not carefully tested 
before being used on humans. After the shock of 
thalidomide, the public and the medical pro- 
fession alike began to give much more attention 
to the unknown effects of medical treatments 
generally and drugs in particular. 

The changes in society's thinking brought about by these 
developments and others like them have been rapid and 
profound. All of them occurred after Dr. Cameron retired 
from the Allan, or just at the end of his tenure there. 

It is difficult now to step back from the new environment 
created by these developments and look at the matter 
through the spectacles of the 1950's and early 1960's, but 
it is essential to do so if we are to render a true 
judgment. Neither legally nor morally should we impose 
today's standards in the matters of consent and choice of 
treatment upon the actions of those who in good faith 
conducted themselves in accordance with the laws and the 
ethics of the day. 




- 95 - 

7. THE INVOLVEMENT OF THE CIA 

A. General conclusion 

There is no doubt that the CIA funded Dr. Cameron to 
conduct research work at the AMI in the field of psychic 
driving, in combination with the usual concomitants of 
depatterning, sleep therapy, sensory isolation and drugs. 
Total funding apparently amounted to $84,820 and was 
spread over six years, from 1957 to 1962. (See Tab H of 
the Affidavit of John Marks in the Orl ikow case, sworn 
April 30, 1981, attached at Appendix 44; there is con- 
flicting information within Tabs G and H as to the exact 
time frame of the funding and the amounts involved, but it 
will be assumed for purposes of this opinion that the 
later date (1962) and the higher amount (stated above), 
are correct.) 

In preparing this opinion, I have not had access to CIA 
file materials, other than the publicly available informa- 
tion specifically referred to. Nor have I had access to 
patient's records. Because of these limitations to my 
mandate, it is impossible to reach a conclusion as to what 
role (if any) the CIA actually played in instigating, 
directing and controlling the treatments given to individ- 
ual patients. It follows that any inferences I may draw 
in this regard are necessarily tentative and speculative. 


96 


What is clear, however, is that the allegations as to 
treatments made by the nine U.S. plaintiffs are consistent 
with the supposition that the CIA was only involved in 
funding and was not involved in instigating, directing and 
controlling Cameron's work; and that Cameron was simply 
applying treatments of a kind which, by the time he 
applied for funding from the Society for the Investigation 
of Human Ecology (the CIA "cover" organization), had 
become standard practice for him. This conclusion is 
based on a comparison of the procedures alleged generally 
by the nine U.S. plaintiffs, with those in general use at 
the time at the Allan; it will be appreciated that, in the 
absence of patient's records, no conclusion can be drawn 
as to the propriety of any particular treatment in the 
case of any particular plaintiff. 

Because questions about what happened at the AMI can be 
answered without reference to the CIA's role, it follows 
that in a sense, the CIA's role is a side issue in 
reaching the conclusions arrived at in the rest of this 
section of this opinion. I have, however, considered it 
important to discuss this role, both to explain how I 
arrived at these conclusions, and because of your request 
that I address the question of the government's wider 
(i.e. extra-legal) responsibilities - a question which, in 
view of the public attention which has been paid to the 
matter of CIA involvement, cannot be fully addressed with- 
out reference to what is known about that involvement. 


97 


B. The context of the times 

During World War II, scientists from the United Kingdom, 
United States and Canada had cooperated to the fullest 
possible extent. This cooperation continued in a quite 
natural way for a long period after the war, heightened by 
the engagement of the three countries in the Korean War of 
the early 1950 ' s. 

The June 1, 1951 meeting that took place in the Ritz 
Carlton Hotel in Montreal, described in section 3 of this 
opinion, was the starting point for cooperative effort 
among the three countries in defence-related research into 
problems of the mind. As a direct result came the 
research on the effects of sensory deprivation carried out 
by Dr. Donald O. Hebb at McGill. 

C. Understanding between Canada and the U.S. 

At that time, so I am advised by Dr. Solandt, Chairman of 
the Defence Research Board from 1946 to 1957, there was an 
unwritten understanding between DRB (including the Chiefs 
of Staff of the Canadian Services, who were members of the 
DRB), and their opposite numbers in the U.S. Defence 
Department and all three U.S. Services, on the subject of 
classified defence-related research. It was agreed that 
neither government would fund defence research of a 


98 


classified nature that was to take place in the other 
country. Instead, if (for example) the U.S. wanted to 
have some research done in a particular field, and 
considered the work could best be done in Canada, they 
would inform the DRB,and if the DRB considered that the 
project fell within its mandate and was not unsuitable on 
some other ground, then the DRB would fund the research 
directly itself. The U.S. did not directly reimburse 
Canada for this work but there was a rough quid pro quo in 
that, when Canada requested the U.S. to do certain work in 
exchange, the work would be done south of the border and 
at U.S. cost. 

The reason for this arrangement was so that Canadian 
researchers would not be placed in the position of being 
under a duty of confidentiality to a foreign government 
concerning the results of the classified research, and as 
a result be unable to transmit the results to their own 
government. 

Dr. Solandt has advised me that on a couple of occasions, 
U.S. government agencies made plans to, or actually 
attempted to, fund classified research in Canada directly, 
in contravention of this unwritten understanding. I am 
not clear whether this was done deliberately or by 
mistake, but in any event the plans or attempts were 
discovered and the projects were either terminated or 
continued by the DRB in collaboration with the U.S. Agency 
that needed to have the work done in Canada. 


99 


I asked Dr. Solandt whether the unwritten understanding 
extended to unclassified work funded by defence agencies 
of the U.S. government. While strictly speaking it did 
not, Dr. Solandt said that Canada would have taken "a 
pretty dim view" of attempts by U.S. defence agencies to 
fund research without checking with the DRB, even if that 
research was not of a classified nature. 

Dr. Solandt had not heard of the Society for the Investi- 
gation of Human Ecology, nor had he heard of any CIA fund- 
ing of research projects in Canada and in particular Dr. 
Cameron's work at the AMI until reading the newspaper 
reports of the past few years. Had he known of such fund- 
ing at the time when he was in the public service he would 
have disapproved of it, even though Dr. Cameron's work was 
unclassified, on the basis that such funding ran counter 
to basic understandings even if not counter to the parti- 
cular unwritten understanding that obtained with respect 
to classified research. 

There was of course, and continues to be, a great deal of 
openly acknowledged funding of unclassified research in 
Canada on the part of U.S. government agencies. These in- 
clude the U.S. Surgeon General, the U.S. Armed Forces, and 
the National Institutes of Health. The point is simply 
that, in Dr. Solandt's view, the ultimate source of fund- 
ing for such work should indeed be openly acknowledged. 


100 


D . The Society for the Investigation of Human Ecology 

The next matter to consider is the composition and prac- 
tices of the Society for the Investigation of Human Eco- 
logy. In accordance with my mandate I have not made any 
enquiries in the U.S. For what follows I have relied on 
publicly available information most of which I have 
located in Canadian Government files. 

The Society for Investigation of Human Ecology, Incor- 
porated ("SIHE") was a research funding agency based in 
New York City. It was incorporated in 1955 by Dr. Harold 
Wolff, a neurologist at Cornell Medical School, with 
himself as President. In 1961 the Society changed its 
name to the Human Ecology Fund, Inc. It received its 
funds from a number of "legitimate" sources, and was also 
used as a "cover organization" through which the CIA 
funded research projects in which it had an interest. The 
CIA closed down the "front" in 1965. 

The Executive Director of the Society was Colonel James 
L. Monroe. His salary was paid by the CIA, according to 
John Marks, author of "The CIA and Mind Control: The 

Search for the 'Manchurian Candidate'" (McGraw-Hill, 

1980). CIA documents confirm that the Cameron project was 
to be monitored by Monroe: see Appendix 45, para. 9(2). 

Monroe visited Dr. Cameron in Montreal while supervising 


V 


101 


the grant. (See letter of Colonel Monroe at Appendix 45A; 
see also Appendix 44, Tab E, where Leonard Rubenstein (an 
associate of Cameron's in the CIA-funded project) says he 
remembers meeting Monroe). Colonel Monroe has stated that 
only 25-30% of the Society's funding came from the CIA 
(Tab E, Appendix 44), but in a newspaper article at the 
same tab. Dr. Lawrence Hinkle, a former director of the 
Society, says most of the support came from the CIA; and 
in his book Marks puts the actual figure at over 90%. 

However this may be, it is clear from U.S. government 
statements that the CIA was involved with Dr. Cameron's 
research, and for purposes of this opinion I have assumed 
that all of such funds originated with the CIA. This 
conclusion seems to be borne out by the CIA materials at 
Appendix 45B. 

A brief word on the background of the MK Ultra program is 
in order. MK Ultra was the name given to an extensive CIA 
program of research into behavioural modification, includ- 
ing the use of drugs and other *-.echniques . The psychic 
driving research which Dr. Cameron carried out with SIHE 
grant money was designated by the CIA as "MK Ultra Sub- 
project 38". 


102 


E . Dr. Cameron's grant application to the SIHE 

On January 21 , 1957, Dr. Cameron made his application to 
the SIHE for a grant for $19,090 for two years. The 
application is attached as Appendix 18. In it will be- 
seen reference to the psychiatric procedures under review 
here. What is clear both from this application and from 
the scientific literature is that Cameron had certainly 
developed and put into practice the techniques of depat- 
terning and psychic driving a number of years before he 
made his application to the SIHE. He stated in his appli- 
cation that the "first objective" of the SIHE research was 
to improve the psychic driving technique. The use of 
specific drugs, including curare, to "inactivate the 
patient" during driving was mentioned. The use of LSD 25 
to "break down ongoing patterns of behaviour" was also 
mentioned. The "second objective" was to measure the 
amenability to change of certain physiological functions 
as a consequence of the repetition of verbal signals. The 
original application was granted and then extended for two 
further years. Altogether, as stated above, Cameron 
received the sum of $84,820 (or rather the AMI received 
this sum, because Cameron's application specified that 
there was to be no remuneration for himself.) 

It should be noted here that, with one exception, no one I 
spoke to had ever heard of the SIHE, or of any CIA funding 


103 


of research in Canada, in particular research at the AMI, 
until reading about it in the newspapers in the late 
1970's and early 1980's. One person. Dr. Ruth Hoyt, 
was once asked at McGill in the 1950's, by persons not 
remembered, if she had heard any rumours about CIA funding 
of Dr. Cameron's research. She had not. 

F. The position of the U.S. government 

The position of the U.S. government is that, while they 
acknowledge the grant from the SIHE to the AMI, and the 
CIA participation in the SIHE, the CIA did nothing more 
than fund an ongoing program of research. They deny that 
the CIA in any way instigated or controlled or directed 
Dr. Cameron in his work. They were simply interested in 
seeing the research program carried out and in obtaining 
the results. A Note from the U.S. Embassy on this point 
is attached as Appendix 48. 

G. T he CIA and Dr. Cameron's research activities 

The question next arises, did the CIA direct, control or 
guide Cameron's research activities in such a way that the 
"treatments” administered to patients were not intended to 
be for their benefit, but instead were intended to be pure 
experiments on unwilling and unwitting victims? 


104 


In attempting to answer this, one must first look at the 
prior question: Did Cameron even know that the CIA was 

behind the grant from the SIHE? 

In the first place, I have seen no direct evidence that 
this was Cameron's purpose. It might be argued that the 
fact that Cameron carried out these highly intrusive and 
intensive procedures at all constitutes such direct evi- 
dence, especially in view of the fact that they did not 
work. But such evidence is equally consistent with the 
conclusion that Cameron's procedures were intended to be 
of benefit to his patients. The fact that they did not 
work is not proof of anything sinister, as there have 
always been and always will be cases of medical misadven- 
ture, where new techniques have been tried and have fail- 
ed. Such evidence is also consistent with the suggestion 
that the CIA was interested in merely supporting on-going 
research in areas of interest to it. It is easy to ima- 
gine why Cameron's research into the techniques of psychic 
driving would be of interest to the CIA in the context of 
its MK Ultra program, even if such research was not con- 
trolled or directed by the CIA. 

Second, all of the medical people with whom I spoke were 
strongly inclined to doubt it, as were almost all the 
other's I spoke to. 




105 


Third, the indirect evidence seems to me to point to the 
conclusion that CIA control of Cameron's work is quite 
unlikely. The following considerations suggest this con- 
clusion: 

(1) It is difficult to believe that an agent of the 
CIA bent on performing "brainwashing" experi- 
ments on unwilling and unwitting victims could 
keep his excesses and ultimate purposes secret 
from the other psychiatrists, nurses and staff 
at the AMI. 

(2) All of the procedures in the sensitive areas - 
depatterning , psychic driving, sensory 
isolation, sleep therapy and psychopharmacology 
- were in fact in use by Cameron long before the 
CIA became involved. The SIHE application only 
proposed improvements in existing psychic 
driving procedures. This is clear on the face 
of Cameron's application to the CIA (see 
Appendix 18) as well as from Cameron's published 
literature. Indeed, at least one of the nine 
U.S. plaintiffs (Mr. Robert Logie) appears to 
have been in and out of the AMI before the 
application to the SIHE for funding was made 
(Sunday Star, Aug. 18, 1985). 


106 


(3) Not only were these procedures widely used, but 
they were widely written about, both in the 
scientific and medical journals and in the 
popular press. Cameron never made any attempt 
to keep his work secret; indeed he flaunted its 
see for example the newspaper article at 
Appendix 48A. He believed in the importance of 
communicating his work to the public, so as to 
create a good name for his Institute and for 
psychiatry in general. It seems to me a servant 
of the CIA would have kept a lower profile. 

(4) In at least three of his publications, Cameron 

did acknowledge the SIHE's funding of his work 
(Appendices 9, 11 and 14); it seems unlikely to 
me that he would give this public acknowledge- 
ment if he knew all along the CIA was behind 
SIHE's funding of the project. Moreover, the 
SIHE in turn referred in public reports to the 
work Cameron was doing in psychic driving: See 

Appendix 44, Tab G. (On the other hand, it 
might be argued that such public acknowledgement 
of a funding source constituted part of the 
"front") . 


107 


(5) Cameron, in fact, put a stop to what he regarded 
as excessive use of massive electroshock by one 
of his associates. This point is discussed by 
Dr. Cleghorn in Appendix 36, Part II, p.71 and 
pp. 88-89. It seems unlikely to me that someone 
whose purpose was to destroy other peoples' 
minds so that he could give the results secretly 
to the CIA would be troubled by the excesses of 
a fellow psychiatrist working with him at the 
AMI . 


(6) At least two of Cameron's H&W projects. Nos. 
604-5-14 (1950-1954; $17,875.00) and 604-5-432 
(1961-1964; $51,860.00) had to do with the same 
subject matter as the SIHE research. One of 
these projects was completed three years before 
the SIHE application was made; the second began 
as the SIHE project was coming to a close. 

These facts suggest that SIHE project was simply 
part of a continuing program of research into 
new psychiatric methods. 

(7) A number of documents suggest he did not know of 
CIA involvement: 

(a) The internal CIA document at Appendix 45 


states as follows: 


108 


"9. In view of the fact that McGill 

University is in Canada, the following 

security consideration should be noted: 

( 1 ) Dr. Cameron, the principal investi - 
gator, and his staff will remain 
completely unwitting of U.S. Government 
interest ♦ 

(2) The project will be monitored by Col. 
James Monroe, staff member of the 
Society. 

(3) No Agency staff personnel will contact, 
visit or discuss this project with Dr. 
Cameron or his staff under extreme 
circumstances . 

(4) If it is necessary for Agency personnel 
to contact Dr. Cameron or his staff, 
the matter will be discussed with the 
Office of Security and the desk 
involved for their evaluation and 
advice as to the proper procedures to 
be taken." (emphasis added) 


(b) John Marks, in his book "The Search for the 
'Manchurian Candidate': The CIA and Mind 

Control", McGraw-Hill, 1980, states in a 
footnote at p.133: 


"Cameron himself may not have known that 
the Agency was the ultimate source of 
these funds which came through a 
conduit, the Society for the Investi- 
gation of Human Ecology. A CIA document 
stated he was unwitting when the grants 
started in 1957, and it cannot be said 
whether he ever found out." 


Chapter 8 of Marks' book, which deals at 
length with Cameron's work, is attached at 
Appendix 46. Mark's request under the U . S 


109 


Freedom of Information Act was the origin of 
much of the subsequent press interest in 
this matter. 


(c) In his testimony of August 3, 1977 before 
the United States Senate, Mr. John 
Gittinger, a former psychologist with the 
CIA, stated (see Appendix 44 Tab F): 


"The Agency in effect provided the 
money. They did not direct the 
projects. Now, the fact of the matter 
is, there are a lot of innocent people 
who received the Society for the 
Investigation of Human Ecology money 
which I know for a fact they were never 
asked to do anything for the CIA but 
they did get through this indirectly. 
They had no knowledge they were getting 
CIA money." 

"I will say it was after the fact 
thinking. It was utter stupidity the 
way things worked out to have used some 
of this money outside the United States 
when it was CIA money. I can categor- 
ically state to my knowledge all the way 
across of the human ecology functions, 
but to my knowledge, and this is 
unfortunate, those people did not know 
that they were getting money from the 
CIA, and they were not asked to con- 
tribute anything to CIA as such." 


(d) The U.S. government has said that available 
evidence indicates that Cameron and his 
staff did not know of CIA involvement: See 


Appendix 48 


(e) 


bidd 


- 110 - 

Leonard Rubenstein, one of Cameron's 
colleagues in the SIHE research, has stated 
that he knew of no CIA connection: See 

Appendix 44, Tab E. 

(f) An External Affairs memorandum to file dated 
March 1, 1984 suggests that a person (name 
deleted, but presumably a colleague of Dr. 
Cameron) was unaware of CIA involvement: 

See Appendix 47. 

On the other hand, on the CBC television show "Fifth 
Estate", Mr. James Turner, law partner of Mr. Joseph L. 
Rauh, U.S. attorney for the nine Canadian plaintiffs who 
have brought suit against the CIA, states that Mr. 
Gittinger caused a representative of the CIA to telephone 
Cameron at the AMI and invite him to apply to the SIHE for 
funding, informing him that the funds originated from the 
CIA. I have not of course seen the basis for Mr. Turner's 
statement, and thus I cannot verify or refute this claim. 

It is of course intellectually conceivable that, at 
bottom, Cameron was a mad scientist, conducting experi- 
ments on unwilling and unwitting victims for some purpose 
other than the ultimate benefit of his patients and at the 


this 

abov< 

In m 
inte 
it i 
inf e 
Pres 
into 
48B) 

Fina 

even 

SIHE 

acce 

of i 

tone 

the 

Cam< 

aloi 

man’ 

he • 

poii 

migl 

was 


and 


bidding of some third party like the CIA. But in my view 
this conclusion is unlikely for all of the reasons given 

above . 

In my opinion, it is more likely that the CIA was simply 
interested in "buying results" in ongoing research which 
it in no way controlled or directed. In drawing these 
inferences I am supported by the view of the former 
President of McGill, Dr. Bell, who had the matter looked 
into from a university perspective in 1979 (See Appendix 
48B). 

Finally, it may be asked whether it makes any difference 
even if Cameron did know that the CIA was behind the 
SIHE's funding. In the cold war climate of late 1950's, 
accepting a research grant from the secret service agency 
of a friendly country would not carry the sinister over- 
tones it does today. The CIA was not as much tarred with 
the "dirty tricks" brush as it is today. If therefore 
Cameron did know of CIA involvement, that fact standing 
alone does not seem to me to be proof of ill intent. Like 
many scientists, Cameron would take grant money wherever 
he could find it without taint: Appendix 47 touches this 

point. Given the climate of the times therefore, one 
might well conclude that Cameron believed the CIA's money 
was indeed untainted, that he accepted it in good faith, 
and that to prove fault it would be necessary to show in 


112 


addition that Cameron had agreed to, and in fact did, 
carry out secret, non-therapeutic experiments on the minds 
of unwilling and unwitting victims. 

H. Conclusions 

If the inferences in the above two paragraphs are correct, 
it follows that the whole question of CIA involvement is a 
red herring in so far as this opinion is concerned. The 
issue here is not whether the CIA ultimately funded some 
of the work of the AMI; the issue is whether the work that 
Cameron did was proper or improper, and whether the 
Canadian government as one of the granting agencies to the 
AMI bears any responsibility in the event such work is 
found to be improper. 

In saying this, I am of course conscious of the fact that 
the CIA funding does raise extremely grave questions about 
the violation of Canadian sovereignty by a foreign govern- 
ment. But however important, these questions raise quite 
separate issues, and they should not be confused with the 
issue with which I am dealing. 

In accordance with my mandate, I have not addressed these 
sovereignty questions. 


113 


In reaching these conclusions I repeat that I have not 
seen any information from CIA files in the possession of 
the U.S. other than the publicly available information 
referred to above. Consequently, my inferences concerning 
Cameron's involvement with the CIA are tentative and 
speculative, and may well need to be changed should the 
Canadian government take up the proposal of the U.S. 
Secretary of State that the CIA files be reviewed by 
Canadian officials, or should other information come to 
light from other U.S. or Canadian sources. (It may even 
be argued that the internal CIA memorandum of October 31 , 
1978 from its General Counsel to Robert H. Wiltse, 
attached at Appendix 48C, itself suggests a conclusion 
opposed to that which I have reached; but this memorandum 
standing alone does not, in my view, assist one way or the 
other. ) 


8. THE ORLIKOW AND MORROW CASES 

Mrs. Velma Orlikow and Dr. Mary Morrow, two of the plain- 
tiffs in the U.S. lawsuit, also brought action in Quebec 
in respect of the treatments they had received at the 
Allan. Summaries of the two cases are attached at Appen- 
dices 49 and 50 respectively. 


114 


A. The Orlikow case 


Mrs. Orlikow 's case was commenced in April, 1979 and was 
settled out of court after evidence was given but before a 
judgment was rendered. Media reports suggest a settlement 
figure of $50,000, being the amount of the fees paid by 
Mrs. Orlikow to the Allan. 

What is clear from the evidence is that Mrs. Orlikow had 
been quite seriously ill since 1951, having been treated 
with little or no improvement by a number of profession- 
als, including staff at the Mayo Clinic. These treatments 
included psychotherapy, electroshock treatment and drugs, 
including Largactil. She came to Dr. Cameron in November, 
1956 on the recommendation of her physician in Winnipeg, 
and remained a patient of Dr. Cameron off and on until 
May, 1964. Following Dr. Cameron's retirement from the 
Allan in 1964, Mrs. Orlikow continued to visit him at his 
Lake Placid home. While under Dr. Cameron's care she 
allegedly underwent depatterning , sensory deprivation, 
psychic driving and psychopharmacolog ical treatments, 
including LSD, sodium amytal , desoxyn and Largactil. 

The expert psychiatric evidence presented at the trial is 
in conflict. Mrs. Orlikow' s expert, Dr. Paul-Hus, testi- 
fied that Cameron's treatments were "very unusual" and of 
an experimental nature. Dr. Alan Mann, the defendant's 


115 


expert, in effect agreed that in general psychic driving 
and electroshock treatments did not work in the manner in 
which they were then applied, but said that both proce- 
dures (i.e. replay of taped messages and electroshock 
therapy) are still in use, though in a different way. He 
said in effect that one had to make allowances for the 
fact that much less was known in the 1950's and early 
1960's about how to treat the mentally ill, and it was in 
light of this lack of knowledge coupled with a strong 
desire to conquer the suffering of the mentally ill that 
one must judge Dr. Cameron's treatments. 

In view of the fact that there are no judicial findings of 
fact in the Orlikow case, conclusions from it are diffi- 
cult or impossible to draw, and I have drawn none for 
purposes of this opinion. 


B. The Morrow case 


Dr. Mary Morrow is a psychiatrist who formerly worked for 
Dr. Cameron at the Allan and had assisted him in admini- 
stering depatterning treatments to patients there. In 
1960 she herself became a patient of Dr. Cameron, and 
received electroshock treatments towards depatterning. In 
1967 she brought action for damages against the Royal 
Victoria Hospital and the estate of Dr. Cameron. 


116 


In a 1978 judgment of the Quebec Superior Court, her 
action was dismissed. 

In January, 1985 the Quebec Court of Appeal permitted Dr. 
Morrow to re-open the case and to introduce new evidence 
not available at the time of the original trial, to the 
effect that the CIA funded Cameron to carry out brain- 
washing on patients. This evidence has now been submitted 
to the Clerk of the Court. I understand, however, that it 
will be at least eighteen months before the court hears 
the appeal based on this new evidence. 

The trial judgment concludes, in effect, that there was no 
wrong-doing by Dr. Cameron, that intensive electroshock 
was a standard procedure at the time, and that Dr. Morrow 
had given full consent to the treatments. 

In view of the strong judgment of Bourgeois, J. of the 
Quebec Superior Court, reached after hearing extensive 
expert evidence (including that of Dr. Robert Cleghorn 
who, incidentally, was called to the stand by the Plain- 
tiff but whose evidence strongly favoured the Defendant), 

I conclude that this case stands as a strong precedent, at 
least on intensive electroshock therapy, and at least 
until the Quebec Court of Appeal renders its decision. 
Since the new evidence taken last year on the subject of 
the CIA's funding of Cameron's research is privileged, I 


117 


have not had an opportunity to review it. I am therefore 
not in a position to predict how the Court of Appeal will 
decide. Depending on how the court decides and on the 
basis of what evidence, the result could well provide a 
very strong precedent at the Appeal Court level, both on 
the question of intensive electroshock therapy and on the 
conclusions to be drawn from CIA involvement in funding 
research at the Allan. 

9. LEGAL PRINCIPLES APPLICABLE TO THIS CASE, AND 

CONCLUSIONS OF LAW 

A. Preliminary assumption 

A complete discussion of the applicable legal principles, 
authorities and my conclusions thereon will be found at 
Appendix 51. These conclusions are based on the assump- 
tion that a potential plaintiff could prove Dr. Cameron's 
conduct to be tortious in the first instance. In my 
opinion, this assumption is not warranted. While the 
matter is not free from doubt, and (as explained above in 
section 5) would be the subject of controversy among 
psychiatrists, in my opinion the weight of evidence and of 
legal precedent points to the conclusion that no tortious 
liability would be found to exist if the matter were 
litigated. Of course, in stating this I am assuming that 
such litigation would be decided on the general question 


of whether Cameron's procedures were proper or improper in 
themselves given the climate and knowledge of the times, 
and would not turn on such questions as whether the parti- 
cular treatments used in the case of a particular plain- 
tiff were appropriate for that individual or, if so, 
whether the treatments were carried out in a negligent or 
a proper manner. 

In reaching this conclusion I have relied on the expert 
opinions of Drs. Grunberg , McDonald and Lowy, as well as 
on the factual analysis set out in the foregoing sections 
of this opinion. 

If this analysis is correct, and a plaintiff could not 
establish legal liability against the Allan or the estate 
of Dr. Cameron, or some other person having responsibility 
for a plaintiff's treatment, then a fortiori no legal lia- 
bility can be established as against the Crown. 

B. Legal analysis 

Assuming, however, that the foregoing analysis is incor- 
rect, and that a plaintiff could prove tortious conduct as 
against the Allan or some other party, the question still 
arises as to whether the Crown is legally liable by reason 
of having funded certain of the research work of Dr. 
Cameron and the Allan. I have reached the conclusion that 


119 


the Crown would not be liable, for the reasons set out in 
Appendix 51. The following is a brief summary of those 
reasons. 

The Crown is liable only under the conditions prescribed 
in the Crown Liability Act . In the context of this case 
it must be shown that a servant or agent of the Crown 
caused damage by his fault or was liable in tort. A 
potential plaintiff might advance three arguments: 

( 1 ) Servant or agent of the Crown 

It might be argued that Dr. Cameron was a 
servant or agent of the Crown for whose torts or 
delicts the Crown is vicariously liable. The 
evidence shows clearly that Dr. Cameron was 
neither a servant nor an agent of the Crown. 
Consequently the Crown cannot be liable on that 
basis. 

(2) Authorization or ratification 

It might also be contended that the tortious 
conduct of Dr. Cameron was authorized or 
ratified by servants or agents of the Crown. By 
using this analysis a potential plaintiff would 
endeavour to attach secondary liability to the 



120 


servant or agent and thereby fix vicarious 
liability on the Crown. Secondary liability, 
whether by way of authorisation or ratification, 
is imposed only where the person sought to be 
made secondarily liable possesses knowledge that 
the acts alleged to have been authorised or 
ratified were tortious in nature. The evidence 
here is, however, bereft of any suggestion that 
any governmental official, whether servant or 
agent, knew of the tortious character of Dr. 
Cameron's research and treatment (assuming such 
tortious character could be proved in the first 
instance). It therefore follows that this 
approach would not result in a finding that the 
Crown was legally liable in respect of Dr. 
Cameron's research. 

(3) Duty to control 

The third avenue of attack for potential 
plaintiffs is to assert that a servant or agent 
of the Crown owed a duty to them to control the 
conduct of Dr. Cameron. The courts have recently 
enlarged the concept of "duty" in cases of this 
kind. A plaintiff could now arguably maintain 
that there is some legal basis upon which a 
granting agency might be legally liable to the 


121 


patient in the event medical research goes 
wrong. (It is interesting to note that the 
National Cancer Institute of Canada has recently 
decided to require grantees and their insti- 
tutions to sign forms of indemnity by which the 
NCI is held harmless in the event suit is 
brought against it for the research activities 
of its grantees: See Appendix 52 attached.) 

Although this expansion of the concept of duty 
has probably not yet run its full course in the 
courts, and may well in future years be 
developed to the point where plaintiffs might 
succeed in a case of this kind, I do not 
consider that the law as it presently stands 
would permit a plaintiff to recover. My reasons 
follow. 

The courts recognize such a duty only in two 
types of case: 

(i) where there is a "special relationship" 
between the defendant on whom such a duty 
is sought to be imposed and the third 
party, here Dr. Cameron, and 

(ii) where there is a "special relationship" 
between the defendant and the plaintiff. 


122 


In the first case, there is a "special relation- 
ship" (and a duty is imposed) only where there 
is a right and ability to control the third 
party. The provision of research funds to Dr. 
Cameron does not carry with it a "right and 
ability" to control him, and thus there was no 
"special relationship" between the Crown and 
Dr. Cameron. 

As for the second case, there is no "special 
relationship" between a potential plaintiff and 
the Crown. 

C. Conclusion 

It therefore follows that in the circumstances the Crown 
is not legally liable for the conduct of Dr. Cameron, 
assuming such conduct could be proved tortious in the 
first instance. 

D. Limitation of Actions or Prescription 

The legal analysis above and in Appendix 51 has been 
carried out without regard to the provisions of any 
applicable law limiting the right of a plaintiff to bring 
action because of the passage of time. 


V 


123 


E. Civil Law 


Mr. James M. Mabbutt, Counsel, Constitutional and 
International Law, Department of Justice has reviewed 
Appendix 51 and has confirmed that, from a Quebec civil 
law viewpoint, the conceptual analysis is complete and 
accurate and supports the conclusion of no delictual 
liability. While I take responsibility for the legal 
research necessary to formulate this opinion, I am not 
qualified to practice in the Province of Quebec, and I 
have therefore relied on Mr. Mabbutt' s opinion in so far 
as conclusions stated herein are controlled by the law of 
Quebec. 


10. THE WIDER RESPONSIBILITIES OF GOVERNMENT 


A. Further discussion of the "penultimate question" 

- whether Dr. Cameron's treatments were proper or 
improper 


Two points arise here: whether the treatments were 

irresponsible or reckless even on the assumption Cameron 
had no knowledge of CIA involvement; and the question of 
that involvement. 


On the first point. Dr. Cameron must have known that the 
large doses of electric shock applied in the depatterning 
procedure, and the large number of seizures produced, 


124 


could result in brain damage. It was well known at the 
time for example that epileptics subjected to many 
seizures often suffered brain damage. And psychic driving 
was largely untried. 

On the other hand, it would appear that the patients 
selected for these treatments were very disturbed, and 
that other psychiatric procedures had failed to help 
them. To the extent that patients' individual medical 
records might show on examination that some individuals 
who were not severely disturbed were subjected to the 
treatment, then for such cases it might be said that the 
treatments bordered on the irresponsible. I of course 
have not seen, nor have I sought, information relating to 
any of the former patients at the Allan, and consequently 
any conclusions would be in the realm of speculation. 

Given the standards of the time, and allowing for his 
ambition, and based on the interviews I have conducted, 
the files I have reviewed and especially on the opinion of 
the three experts with whom I have consulted, I have 
reached the view that Dr. Cameron was operating within 
those standards. Perhaps the conclusion that comes 
closest to the truth is that he acted incautiously, but 
not irresponsibly. Most psychiatrists did not make the 
mistakes he did in developing and applying the depat- 
terning and psychic driving techniques, but this was out 


125 


of a sense of caution in the face of the highly intrusive 
and extremely intensive nature of the treatments. 

As for the second point, all medical treatments (even 
aspirin) involve a balancing of pros and cons, an exercise 
of judgment. Very few treatments are wholly innocuous. A 
patient is entitled to a physician's judgment, exercised 
on behalf of the patient and no one else, as to whether 
the proposed treatment constitutes a reasonable 
"cost-benefit". Were Dr. Cameron's assessments carried 
out on the patients' behalf, or for other purposes? I 
have not seen enough evidence to allow a factual 
conclusion to be drawn on this point; and of course one 
cannot read the heart, even after all the evidence is in. 
In my view, the evidence that is available is consistent 
with the conclusion that he did in fact exercise his 
judgement on his patients' behalf. 

B. The "ultimate" question — the Crown's 
responsibility 

I turn now to the ultimate question. Let us assume, con- 
trary to my own conclusion, that Dr. Cameron did in fact 
carry out procedures on patients for some purpose other 
than the patients' benefit. Alternatively, and less 
menacingly, let us assume that Dr. Cameron did in fact 
blur the distinctions among experimentation, new 
techniques intended to be therapeutic (therapeutic 
trials), and routine treatment. Let us further assume in 


126 


both cases that some individual patients were not helped 
but suffered damage. On these assumptions, the question 
is: Does the Government of Canada bear any moral res- 

ponsibility towards those patients? 

In my opinion, given the climate of the times, and the 
prevailing practices as to medical research and experimen- 
tation, ethics and consent, the Government of Canada can- 
not be expected to bear responsibility for what happened 
at the AMI, even assuming (contrary to my own conclusion 
on the point) that Dr. Cameron crossed over the line of 
the acceptable in medical research. The government's 
research grants were at all times subject to reviews both 
internal and external; no adverse comments were brought 
to the attention of those responsible. 

The granting agencies did not know - and could not know - 
of any ulterior motive on Cameron's part (assuming there 
was one). Nor, given the way these questions were common- 
ly dealt with at the time, did they know - or could they 
know - of any failure on Dr. Cameron's part to observe the 
distinctions among experimentation, therapeutic trials and 
routine treatment. 

It is difficult to see how moral responsibility can lie on 
the government in such a situation. 


127 


In Appendix 53 will be found a discussion of the question 
of compensation in the absence of legal or moral responsi- 
bility. 


11. FINAL CONCLUSIONS 


For the reasons stated in sections 9 and 10, in my opinion 
the Government of Canada bears no legal or moral responsi- 
bility for the activities of Dr. D. Ewen Cameron. I 
repeat that this conclusion does not mean that no one has 
a cause of action on the ground that some particular 
course of treatment was inappropriate for the illness 
being treated, or inexpertly or improperly administered. 


I will conclude with a statement of Lord Denning, M.R., a 
statement roughly contemporaneous with the matters in 
issue here, in Roe v. Minister of Health , [1954] 2 Q.B. 
66, at pp. 83-84, cited by Bourgeois, J. in the Morrow 
case: 


"It is so easy to be wise after the event and to 
condemn as negligent that which was only a 
misadventure. We ought always to be on our guard 
against it, especially in cases against hospitals 
and doctors. Medical science has conferred great 
benefits on mankind, but these benefits are attended 
by considerable risks. We cannot take the benefits 
without taking the risks. Every advance in 
technique is also attended by risks. Doctors, like 
the rest of us, have to learn by experience; and 
experience often teaches in a hard way. Something 
goes wrong and shows up a weakness, and then it is 


128 


put right. That is just what happened here. Dr. 
Graham sought to escape the danger of infection by 
disinfecting the ampoule. In escaping the known 
danger he unfortunately ran into another danger. He 
did not know that there could be undetectable 
cracks, but it was not negligent for him not to know 
it at that time. We must not look at the 1947 
accident with 1954 spectacles." 

and later, at pp. 86-87: 

"One final word. These two men have suffered such 
terrible consequences that there is a natural 
feeling that they should be compensated. But we 
should be doing a disservice to the community at 
large if we were to impose liability on hospitals 
and doctors for everything that happens to go 
wrong. Doctors would be led to think more of their 
own safety than of the good of their patients. 
Initiative would be stifled and confidence shaken. 

A proper sense of proportion requires us to have 
regard to the conditions in which hospitals and 
doctors have to work. We must insist on due care 
for the patient at every point, but we must not 
condemn as negligence that which is only a 
misadventure. " 


In my view, this passage is particularly appropriate in 
the circumstances under review in this opinion. 


Yours very truly. 



George T.H 


Cooper 


129 


APPENDICES 


Appendices 4, 5 and 6 are reproduced with this opinion. 
The full appendices are available at the following 
locations: 


Department of Justice Regional Offices 


Medical Faculty libraries 


Major Municipal Libraries 


Law Libraries 


130 


LIST OP APPENDICES 


1. Plaintiffs' Second Amended Complaint in US Lawsuit - 
June 3 , 1983 

1A. Letter from plaintiffs' attorney detailing basis for 
plaintiffs' claim - February 24, 1984 

2. List of persons interviewed 

3. List of files reviewed 

4 . Expert opinion and C.V. of Dr. Frederick Grunberg 

5. Expert opinion and C.V. of Dr. Ian M. McDonald 

6. Expert opinion and C.V. of Dr. Fred H. Lowy 

7. D. EWEN CAMERON - Psychic Driving. American Journal 
of Psychiatry, 112 (7), 1956 

8. D. EWEN CAMERON - Psychic Driving: Dynamic Implant. 

Psychiatric Quart. 31: 703-712, 1957 

9. D. EWEN CAMERON & ROBERT B. MALMO - Effect of 
Repeated Verbal Stimulation upon a Flexor-extensor 
Relationship. Canadian Psychiatric Association 
Journal, Vol. 3, No. 2, April 1958 

10. D. EWEN CAMERON & S.K. PANDE - Treatment of the 
Chronic Paranoid Schizophrenic Patient, Canada 
M.A.J. Jan. 15, 1958, Vol. 78, pp. 92-95 

11. D. EWEN CAMERON, LEONARD LEVY, L. RUBENSTEIN & R.B. 

MALMO - Repetition of Verbal Signals: Behavioural 

and Physiological Changes. American Journal of 
Psychiatry, 115 (11), 1959 

12. D. EWEN CAMERON, LEONARD LEVY & LEONARD RUBENSTEIN 
Effects of Repetition of Verbal Signals upon the 
Behaviour of Chronic Psychoneurotic Patients. 

J.Ment. Sci., 106, No. 443, April 1960 

12A. D. EWEN CAMERON, Production of Differential Amnesia 
as a Factor in the Treatment of Schizophrenia. Comp. 
Psychiat. , Vol. 5, 1960, pp. 26-34 

13. D. EWEN CAMERON, LEONARD LEVY, THOMAS BAN & LEONARD 
RUBENSTEIN - Repetition of Verbal Signals in Therapy 
Current Psychiatric Therapies, pp. 100-1 11, Ed. J. 
Masserman, Grune & Stratton Inc., New York-London, 
1961 


131 


14. D. EWEN CAMERON, LEONARD LEVY, THOMAS BAN & LEONARD 
RUBENSTEIN - A Further Report on the Effects of 
Repetition of Verbal Signals Upon Human Behaviour. 
Canadian Psychiatric Association Journal, Vol. 6, 

No. 4, August 1961 

15. D. EWEN CAMERON, J.G. LORENZ & K. A. HANDCOCK - The 
Depatterning Treatment of Schizophrenia. 

Comprehensive Psychiatry, Official Journal of the 
American Psychopathological Association, Vol. 3, 

No. 2, April 1962 

16. D. EWEN CAMERON, LEONARD LEVY, THOMAS BAN & LEONARD 
RUBENSTEIN - Automation of Psychotherapy. 
Comprehensive Psychiatry, Official Journal of the 
American Psychopathological Association, Vol. 5, 

No . 1 , February 1964 

17. L. LEVY, D.E. CAMERON, T. BAN & L. RUBENSTEIN - The 
Effects of Long-term Repetition of Verbal Signals. 
Canadian Psychiatric Association Journal, Vol. 10, 

No. 4, August 1965 

18. Dr. Cameron's grant application to the Society for 
the Investigation of Human Ecology, Jan. 21, 1957 

19. Extracts from and discussion of material in a 
Ministerial Return by Hon. J. Waldo Monteith, 

Minister of National Health and Welfare, on the 
subject of LSD (undated: 1962 or 1963) 

19A. NRC grants-in-aid for psychiatry 

20. Report concerning communist "brainwashing" techniques 
during the Korean War, Sept. 14, 1950 

21. Minutes of June 1, 1951 Canada/US/UK meetinq re: 
communist "brainwashing" techniques during the 
Korean War 

22. DRB file materials on research by Dr. Donald 0. Hebb 
on sensory deprivation experiments 

23. DRB file materials, correspondence and news clippings 

24. DRB report to Treasury Board, August 3, 1954 

25. Letter from Dr. Cormier to Dr. Hebb, Dec.1, 1953 

26. Health and Welfare application form and memoranda 
on research grants 

. HWC response to ATI request, showing nine Mental 
Health Division research projects listing the name 
of Dr. Ewen Cameron as principal investigator - 
Apr i 1 5 , 1985 


27 


132 


28. Final report on Project No. 604-5-14 

29. Final report on Project No. 604-5-432 

30. Summary of Project No. 604-5-13 

31. File document and abstract on Project No. 604-5-74 

32. Newspaper article - Dr. Heinz E. Lehman - May 16, 
1964 



33. Memorandum to the Hon. Paul Martin, Jan. 18, 1949 

34. Memorandum of Dr. Charles Roberts, April 8, 1953 

35. Newspaper article - Dr. D.E. Cameron - May 15, 1957 

36. Extracts from Dr. Robert A. Cleghorn's private papers 

36A. Journal extracts on Dr. D.E. Cameron - 1965 and 1967 

37. Extracts from paper by Dr. J.W. Fisher (undated: 1952 
or 1953) 

38. A.E. SHWARTZMAN & P.E. TERMANSEN - Intensive 

Electroconvulsive Therapy: A Follow-up Study. 

Canadian Psychiatric Association Journal, Vol.12, 

No. 2, 1967 

38A. Extract from Kalinowsky and Hoch, "Shock Treatments, 
Psychosurgery and Other Treatments in Psychiatry" , 
1957 


39. "Ethics in Human Experimentation", Medical Research 
Council of Canada's Working Group on Human 
Experimentation, Report No. 6, 1978 

40. Current MRC guidelines for grant application, and 
Ethics Certificate 


45A. Li 
A] 

45B. Ii 

Si 


46. Cl 
ai 
c, 

47. E 


48. N' 

48A. N 
M 

48B. E 
m 

48C. I 
R 

49. S 

50. S 
51 . M 

52. V 

C 

53. I 
I 


41. Application form of Dr. D. Ewen Cameron for Project 
No. 604-5-433 

42. Consent forms, Orlikow and Morrow cases, and for two 
other U.S. plaintiffs 

43. "Patients 's Rights and Ethics Committee, Douglas I 

Hospital Centre", by Wilson & Steibelt. Canada's 

Mental Health, Vol.33, No. 3, September 1985 

44. Affidavit of John Marks dated April 30, 1981, filed 
in the Superior Court of Quebec in the Orlikow case 

45. Internal CIA memorandum on MK Ultra Subproject 68, 

Feb. 26, 1957 




133 


45A. Letter of Col. James L. Monroe to Dr. Cameron, 

April 23, 1959 

45B. Internal CIA documents on funding of MK Ultra 
Subproject 68 

46. Chapter 8, "Brainwashing", from John Marks, "The CIA 
and Mind Control: The Search for the 'Manchurian 
Candidate'," McGraw-Hill, 1980 

47. External Affairs memo to file, March 1, 1984 

48. Note from the U.S. Embassy to Canada, April 12, 1984 

48A. Newspaper article. Dr. D.E. Cameron, Calgary Herald, 
May 15, 1957 

48B. External Affairs letter of June 15, 1919 and 

materials on McGill's view of Dr. Cameron's work 

48C. Internal CIA memorandum from General Counsel to 
Robert H. Wiltse, October 31, 1978 

49. Summary of the Orlikow case 

50. Summary of the Morrow case 

51. Memorandum of law 

52. Memorandum of the National Cancer Institute of 
Canada, October, 1985 

53. Memorandum on Compensation in the Absence of Legal or 
Moral Responsibility 



Page 1 


REPORT TO GEORGE T.H. COOPER , Q.C. 


I - THE WORK OF DR D.E. CAMERON 


From the early fifties to the mid sixties. Dr D. Ewen 
Cameron had been working at the Allan Memorial Institute of 
Montreal on modifying the behaviour of chronic 
psychoneurotic patients by utilizing a psychotherapeutic 
procedure which he called "psychic driving" . 


At the Illth annua! meeting of the American Psychiatric 
Association in Atlantic City, May 11, 1955, Dr D.E. Cameron 
read a paper entitled: "Psychic Driving: Dynamic 

Implant" * in which he describes his psychotherapeutic 
technique : 

"Briefly , it is the exposure of the patient to continued 
replaying , under controlled conditions , of a cue 
communication derived from one of the original areas from 
'jhich his current difficulties arise. A major consequence 
of such exposure is to activate and bring progressively into 
his awareness more recollections and responses generally 
from this area. The ultimate result is the accelerating of 
therapeutic reorganization" . 


Subsequently, Dr D.E. Cameron and al read papers on this 
subject at meetings of learned societies such as the 
Canadian Psychiatric Association, the American Psychiatric 
Association, the Royal Medico-Psychological Association, the 


* This paper was subsequently published in Psychiatric Quart 
31: 703-712, 1957. 


Page 2 


World Congress of Psychiatry and published the results of 
this work in journals such as the Canadian Psychiatric 
Association Journal, the American Journal of Psychiatry and 
the Journal of Mental Science. ** 


In two of his papers. Dr D.E. Cameron acknoledged the 
assistance of grants from the Society for the Investigation 
of Human Ecology and from Dominion-Provincial Mental Health 
Grand Project no 604-5-432. 

The description of the technique, the reporting of the 
results, and the theoretical frame work of Dr D.E. Cameron's 
work can best be found in my opinion in a chapter entitled: 
"Repetition of verbal signals in Therapies" published 
in "Current Psychiatric Therapies" Ed. J. Masserman, Greene 
& Stratton, N.Y. - London, 1961. I shall summarize this 
chapter with my personal comments in bracket. 

A) THE PROCEDURE: 

1.- Selection: 


Chronic psychoneurotics who have failed to respond 
to other methods of treatment. 

(At that time particularly in North America the 
treatment of choice of such patients was psycho-analysis 
or psycho-analytically oriented psychotherapy. In 
general 'Jith the techniques available at the time the 
treatment vas long and expensive. Dr Cameron believed 
that 'j)ith his technique he could reduce the length of 
treatment and thus the cost. Furthermore I should add 
that such patients are for the most competent and submit 
to treatment on a voluntary basis). 


** The reader will find in appendix I a bibliographical 
listing of Dr D.E. Cameron publications on the subject. 


Page 3 


2.- Assessment: 


a ) The conventional psychiatric interview or the 
psychiatric interview carried out under 
disinhibiting drugs together with a record of the 
patient's evaluation of himself. 

(Since the end of the second Morld Mar 
desinhibit ing drugs such as sodium amytal a 
barbiturate or desoxyin an amphetamine Mere often 
used in the fifties to uncover repressed 
psychological material or to obtain emotional 
abreactions . I Mould add that in the fifties many 
psychiatrists and psychologists Mere experimenting 
Mith hallucinogenic drugs such as LSD 25 or 
mescaline as desinhibit ing drugs or drugs that 
could induce a model psychosis ) 

b) Social Service report. 

c ) Psychological tests. 

d) Movies taken in four differents and 
standardized situations. 


e ) A battery of conditioned reflex tests. 


f ) Electronic analysis of the voice. 

(In spite of all the gadgetry none of those tests 
could be considered intrusive Mith a potential for 
harm ) . 


3 . - Preparation of the patient. 


Three principal methods of preparing the patient 
were utilized by Dr Cameron. 


Page 4 


a) The depatterning by means of prolonged sleep 
and intensive electroshock. 

b) Small doses of tubocurare in beeswax given 
intra-muscularly to produce relative immobilization 
on the part of the patient in order to maintain him 
in the area of repetition. 

c ) Putting the patient under an ordinary hospital 
baker producing a relaxing degree of warmth. 

(The preparation of the patient is may be the most 
controversial aspect of Dr Cameron's procedure of 
psychic driving because of its intrusiveness . 
However Dr Cameron believed in the necessity >s>ith 
the intractable psychoneurotic patient of breaking 
do'Jn his long standing maladaptive patterns of 
behaviour and thus facilitating the establishment 
of ne'j) and more adaptive patterns by exposure to 
repetition or psychic driving . 

By today’s standards depatterning especially by 
intensive electroshock is repugnant . However in 
the context of the time the methods of psychiatric 
treatment u )ere very intrusive particularly the 
biological interventions such as Insulin Therapy 
and continuous narcosis. It it true that those 
intrusive methods uere utilized essentially u)ith 
psychotic patients rather than vith the 
psychoneurotics although prolonged sleep <jas uiuite 
popular in Europe uith the latter). 

4 . - The preparation of signals: 

The material of the signals is derived from the 
following sources: psychodynamic interviews, 

reports from relatives, social service studies and 
psychological tests. On the basis of all those 
reports negative and positive statements are 
prepared and recorded. The negative statements 
face the patient with the neurotic difficulties 




Page 5 


from which he has attempted to escape, while the 
positive signals represent his aspiration tb be a 
more effective person. They are phrased as far as 
possible in terms of the patient’s own thoughts and 
in the idiom he has used to express his hopes and 
longings . 

Presentation of signals: 

These statements are recorded and played 
continuously from 6 AM to 9 PM daily. During this 
period the patient is lying in bed and listening to 
the recording - which is fully audible - by means 
of a pillow speaker. It is estimated that the 
negative and positive signals combined are repeated 
between 250,000 and 500,000 times during the course 
of the exposure. 

The negative signals which are run first are 
ordinarely accepted by the patient during the first 
few days but there gradually appears an increasing 
degree of hostility towards them which reaches a 
crescendo at the end of ten days. The patient is 
then switched to the positive signals which he 
accepts at once with a sense of relief and he 
continues to demonstrate this satisfaction for a 
varying period. However he soon becomes restless 
and irritable, wanting to be up and around and 
putting his new found behavioral pattern into 
practice . 

The period of exposure to the negative and positive 
statements usually last about ten days each. 


Page 6 


6.- Reinforcements: 


During the period of exposure to intensive psychic 
driving the staff working with the patient are 
briefed concerning the nature of the changes that 
are being sought and instructed to give 
encouragement and social acceptance on the 
appearance of such changes. Concurrently the 
Social Service Department works with the family in 
an attempt to change their attitudes towards the 
patient. 

Once the intensive driving has been terminated, the 
patient remains on positive driving from two to 
four hours a day. During the remainder of the day 
he works in occupational therapy where he is 
encouraged by the staff to put into practice the 
new behavioral pattern. 

In many instances plans are made for the patient to 
be discharged in selected foster homes rather than 
in their own home for a period of three months 
until a new behavioral pattern has been firmly 
established . 

7.- Reassessment: 


Subsequent to the patient's return home a 
reassessment is carried out for a follow up period 
of at least a year. The patient attends the 
Institute and listen to his recording for at least 
one hour twice or three times a week. 


Page 7 


B) THE RESULTS: 


In this paper. Dr Cameron reports: 


"With regard to results in different categories of 
illness Je may say that the extent of the changes jhich 
ve have been able to produce in chronic schizophrenics 
jas small. Our best results have been jith the chronic 
psychoneurotics - and other vise untreatable patient - 
patients , usually jith a long standing character 
neurosis. With these patients our results have been 
increasingly encouraging and je nou consider that the 
procedure of our choice Jhen faced 'Jith such a cases". 

C) THEORETICAL CONSIDERATION: 


The work of Dr D.E. Cameron are based on the following 
theoretical constructs: 


1) The human organism is exceptionally adaptive and 
tends to respond to all in coming stimuli. 


2) Exposure to constant repetition constitutes a 
powerful force and from the uncontrolled effects of this 
force the human organism attempts to protect itself. 

3) There are a large number of mechanism, both at the 
behavioral and at the neurophysiological levels which 
exists simply for this purpose. 


II ~ THE SCIENTIFIC VALUE OF DR D.E. CAMERON WORK 

ON PSYCHIC DRIVING 


The theoretical frame work of Dr D.E. Cameron is quite weak 
and somewhat naive based on a over simplified extrapolation 


Page 8 


of neurophysiological concepts to a complex behavioral 
level . 

Also from a methodological stand point the testing of the 
therapeutic value of this treatment was totally uncontrolled 
based essentially on biased subjective evaluation and on 
irrelevant pseudo-objective parameters such as movies taken 
in four different and standardized situation, a battery of 
conditioned reflex tests and the use of the plethysmograph 
to measure skin resistance. 

By to day standards this was bad science with heavy reliance 
on gadgetry rather than on reflective scientific thinking. 


Ill - THE ETHICS OF DR D.E. CAMERON EXPERIMENT 


A) BY TO DAY STANDARDS: 


Dr Cameron would have had to submit to the following 
procedure before being allowed to carry out his 
experiment: 

1 ) Submission of the project to the hospital research 
committee : 


There is a good chance that Dr Cameron project would 
have been stopped at this level because of poor 
methodology and muddled theoretical basis. 

2 ) Evaluation by the Hospital Ethics Committee: 


Three principles would be taken into consideration 


Page 9 


before granting approval to the project. 

a ) Voluntariness : 

The committee would have to be assured that the patients 
participating in the project would be doing it on a 
completely voluntary basis without any form of coercion. 
The ethics committee would also have to be assured that 
the patient could withdraw from the project at any time. 

b ) Informed consent; 

The ethics committee would have to be assured that the 
patient participating in Dr Cameron's experiment gives a 
written informed consent to his participation after the 
procedure and the rationale of the experiment were 
clearly explained to him Vith all the risks and benefits 
clearly stated. 

c ) Benefit to the patient: 

With this type of experiment the ethics committee would 
have to be satisfied that the patient could derive a 
substantial and direct therapeutic benefit after all 
other non intrusive methods had failed. I believe that 
under present conditions Dr Cameron would have had a 
great deal of difficulties dotay in obtaining approval 
from a Hospital Ethics Committee to carry out his work 
because of its intrusiveness and the present 
availability of a range of new therapeutic techniques. 

B) BY THE STANDARDS OF THE FIFTIES: 


In my opinion it would be a mistake to believe that 


Page 10 


ethical considerations in human experimentation were not 
present at the time. However in this period when 
medical paternalism was still prevailing the ethics of 
an experimental procedure were very much left to the 
judgement and the conscience of the researcher and his 
associates. No formal procedures were in force. 


In 1865, Claude Bernard * wrote on human 
experimentation : 

"Experiments, then, may be performed on 
man, but within uhat limits? It is our 
duty and our right to perform an 
experiment on man whenever it can save 
his life, cure him or gain him some 
personal benefit . The principle of 
medical and' surgical morality, 
therefore , consists in never performing 
on man an experiment 'jhich might be 
harmful to him to any extent, even 
though the result might be highly 
advantageous to science, i.e., to the 
health of others. But performing 
experiments and operations exclusively 
from the point of vie'j) of the patient 's 
O'jn advantage does not prevent their 
turning out profitably to science... 

For ve must not deceive ourselves , 
morals do not forbid making experiments 
on one's neighbor or on one’s self. 
Christian morals forbid only one thing, 
doing ill to one's neighbor. So, among 
the experiments that may be tried on 
man, those that can only harm are 
forbidden , those that are innocent are 
permissible , and those that may do good 
are obligatory" . 


* Claude Bernard, An Introduction to the Study of 
Experimental Medicine (1865). Trans, by Henry C. Green (New 
York: Dover Publications, 1957). 




Page 11 


This in my opinion were the prevailing ethical 
considerations at the time when Dr Cameron carried out 
his work and I believe that he adhered to it because he 
was convinced that those chronic psychoneurotics who had 
not been helped so far could gain from submitting to 
psychic driving. There is no doubt in my mind after 
reviewing carefully Dr Cameron's papers on the subject 
that therapeutic consideration were paramount in his 
motives although I personaly disagree and disagreed then 
with the intrusiveness and lack of scientific rigor of 
his work. 


The Government of Canada funded Dr Cameron's work through 
the Dominion-Provincial Mental Health grants which I believe 
were administered at the time by the Mental Health Division 
in the Department of National Health and Welfare. 

There is no doubts that the scientific standards of the peer 
review committee set up by the Mental Health Division were 
not as rigorous as today's Medical Research Council. 

However Canadian Psychiatry was very much at that time in 
its infancy, the Allan Memorial Institute was very much its 
Mecca and to some extent Dr D.E. Cameron was its prophet. 

In my opinion in spite of all the media noise there is no 
evidence that psychic driving did any irreparable harm to 
patients who voluntary submitted to it. The Canadian 
Government should not bare any moral responsability for 
supporting a project that was essentially therapeutic in its 
aims. r 


IV ~ THE ROLE AND THE RESPONSABILITIES 
OF THE GOVERNMENT OF CANADA 



FG/da 

December 1985 


Frederic Grunberg, m.d., F.R.C.P. (C) 
Professor, Dept of Psychiatry 
University of Montreal 


BIBLIOGRAPHY 


1. - D. EWEN CAMERON - Psychic Driving. American Journal of 

Psychiatry, 112 (7), 1956 

2. - D. EWEN CAMERON - Psychic Driving: Dynamic Implant. 

Psychiatric Quart 31: 703-712, 1957 

3. - D. EWEN CAMERON & ROBERT B. MALMO - Effect of repeated 

verbal stimulation upon a f lexer-extenser relationship. 
Canadian Psychiatric Assoc. Journal, Vol. 3, NO 2 , 

April 1958 

4. - D. EWEN CAMERON, LEONARD LEVY, L. RUBENSTEIN & R.B. 

MALMO - Repetition of verbal signals: behavioural and 

physiological changes. American Journal of Psychiatry, 
115 (11), 1959 

5. - D. EWEN CAMERON, LEONARD LEVY & LEONARD RUBENSTEIN - 

Effects of repetition of verbal signals upon the 
behaviour of chronic psychoneurotic patients. J. Ment. 
Sci, 106, no 443, April 1960 

6. - Proceedings - The Third World Congress of Psychiatry, 

Montreal, Canada - 4/10 June 1961, University of 
Toronto Press, McGill, University Press 

7. - D. EWEN CAMERON, LEONARD LEVY, THOMAS BAN & LEONARD 

RUBENSTEIN - Repetition of verbal signals in therapy: 
in current psychiatric therapies. Ed. J. Masserman, 
Greene & Stratton, New York, London 1961 

8. - D. EWEN CAMERON, LEONARD LEVY, THOMAS BAN & LEONARD 

RUBENSTEIN - A further report on the effects of 
repetition of verbal signals upon human behaviour. 
Canadian Psychiatric Association Journal, Vol. 6, no 4, 
August 1961 

9. - D. EWEN CAMERON, LEONARD LEVY, THOMAS BAN & LEONARD 

RUBENSTEIN - Comprehensive Psychiatry. Official 
Journal of the American Psychopathological Association, 
Vol. 5, No 1, Fevruary 1964 

10. - L. LEVY, D.E. CAMERON, T. BAN & L. RUBENSTEIN - The 

effects of long-term repetition of verbal signals. 
Canadian Psychiatric Association Journal, Vol. 10, no 
4, August 1965 


CURRICULUM VITAE 


NOM: GRUNBERG, Frederic Maril et pere de deux enfants 

Adresse: 4065 C8te des Neiges, app. 6, Montreal, Quebec H3H 1W7 

Telephone: 937-6926 (residence) 

253-8200 poste 219 (bureau) 

Titre: professeur, depatesrsnt de psychiatrie 

Faculty de mldecme , Universite de Montreal 
coordonnateur du Service de 1 ' enseignement universitaire 
HSpital Louis-H. Lafontaine 

Date de naissance: 21 avril 1927 Nationality: canadienne 

Lieu de naissance: Alexandrie, Egypte 


ETUDES : 
Secondaires : 


Institutions 

Lycee franqais d'A- 
lexandrie 

Lycle franqais d*A- 
lexandrie 


Annie Dipl&mes 

1944 Baccalaurlat 
(lire partie) 

1945 Baccalaurlat 
(2e partie, phi 
losophie) 


Universitaires : 


Institutions Annie Djpldmes Discipline 


Universite de Mont- 1946 PCB 

pellier, Faculte 
des Sciences 

Universitl de Mont- 1952 Doctora t 

pellier, Faculte 
de Medecine 


Certificat des 
sciences physiques, 
chimiques et bio- 
logiques 

Mldecine 


Post-universitaires : 


Universitl de Lon- 1956 DPM 
dres, Institute of 
Psychiatry 


Diploma in psy- 
chological medicine 


• • 


/2 


2 


FORMATION HOSPITALIERE : 


Date 

KSDitaux 

Service 

Fonction 

Responsable 

01-53 

Bethlem Royal 

Psychiatrie 

Clinical 

A. Harris, 

09-53 

Londres 

generale 

Assistant 

M.D. , D.P.M. 

10-53 

Maudsley 

Psychiatrie 

Senior 

A. Lewis, 

09-54 

Hospital 

Londres 

generale 
Professo- 
rial Unit 

House 

Officer 

M.D. , F.R.C.P. 

10-54 

03-55 

Maudsley 

Hospital 

Londres 

Psychiatrie 

infantile 

Registrar 

K. Cameron, 
M.D. , F.R.C.P. 
(Ed. ) 

04-55 

09-55 

Maudsley 

Hospital 

Londres 

Psychothe- 

rapie 

Registrar 

K. Taylor, 
M.D. , D.P.M. 

10-55 

03-56 

Guy's Hospi- 
tal 

Londres 

Neurologie 

Neuro-chi- 

rurgie 

Registrar 

Murray Fulconer 
F .R.C.S. 

04-56 

06-56 

Maudsley 

Hospital 

Psychiatrie 

legale 

Registrar 

P. Scott, 
M.D., D.P.M. 


Londres 


LICENCES, CERTIFICATE , FELLOWSHIPS : 

1956 London University: Academic Post Graduate Diploma in 

Psychological Medecine 

1957 College Royal des Medecins et Chirurgiens du Canada, 
Certificat - psychiatrie 

1958 Licence du Conseil Medical du Canada 

1958 Licence du College des Medecins et Chirurgiens de la 
Saskatchewan 

1961 Licence du College des Medecins et Chirurgiens de l'Al- 
berta 

1970 Licence du departement de 1' Education de l'Etat de 
New York (medecine) 

1974 Fellowship du College Royal des Mldecins et Chirurgiens 
du Canada 

1976 Licence de la Corporation Professionnelle des Medecins 
du Quebec 


• • • 


/ 3 


3 


LICENCES , CERTIFICATS, FELLOWSHIPS (suite): 

1 1977 Certificat ae specialite en psychiatrie, Corporation 
Prof essionnelle des Medecins Specialistes du Quebec 

TITRES: 

1954 Prix de th£se "Montpellier Medical" 

Laureat de la Faculte de Medecine de Montpellier 

1968 Award of Honor - Letchworth Village Chapter, New York 
State Association of Retarded Children Inc. 

1973 Meritorious Service Award, New York State Dept of 
Mental Hygiene 

1973 Meritorious Service Award, New York State United 
Cerebral Palsy 


EXPERIENCE: 



Date 

Institution ou organisms 

Poste occupe 

1956 1 1958 

Reginal General Hospital, Munroe 
Wing 

Senior psychiatrist 

1958 a 1960 

Swift Current Mental Health Cli- 
nic, Sask. 

Directeur 

1960 a 1962 

Yorkton Mental Health Clinic, 
Sask. 

Directeur 

1962 a 1964 

Sask. Hospital Weyburn 

Surintendant 

1964 a 1966 

Sask. Dept of Public Health 
Hospitals Branch 

Directeur 

1966 a 1967 

Sask. Dept of Public Health, 
Psych. Serv. Branch 

Directeur 

11967 a 1973 

New York Dept of Mental Hygiene, 
Albany, New York 

Deputy Commissioner 

Avril 197 3 
i 1976 

Albany Medical College, Albany, 
New York 

Professeur agrege 
Chef de service 

1976 a 1981 

Universite de Montreal, 
Departement de psychiatrie , 
Faculte de medecine. 

Professeur agregl 

1981 a date 

Hdpital Louis-H. Lafontaine 

Coordonnateur du 
Service de l'enseigne 
ment universitaire 


Universite de Montreal, 
Departement de psychiatrie, 
Faculte de medecine. 

Professeur titulaire 


. . ./4 


4 


SOCIETES SAVANTES ET COMITES: 

Date Organisme 

1957 Association des Medecins de Langue 
Franqaise du Canada 

1958 Association Medicale du Canada 

1958 Association des Psychiatres du 

Canada 

1958 College des Medecins et Chirurgiens 
de la Saskatchewan 

1961 College des Medecins et Chirurgiens 
de 1* Alberta 

1963 College Royal des Medecins et 
Chirurgiens du Canada 

1964 Gouvernement du Canada, Ottawa 

Ministere de la Sante et du 

Bien-§tre 

Comite Consultatif de 1* Assurance 
Hospitaliere 

1964 Advisory Council to the College 
of Medecine - University of 
Saskatchewan 

1965 Gouvernement du Canada 

Ministere de la Sante et du Bien- 

§tre 

Comite technique ad hoc sur le 
fond des ressources de la Sante 

1965 Gouvernement de la Saskatchewan 
Comite ad hoc sur 1' education 
du "nursing" 

1966 Association des Psychiatres du 
Canada 

1967 State of New York Department 
of Mental Hygiene 

Committee on the recodification 
of the Mental Hygiene Law 

1968 Letchworth Village Chapter, New 
York State 

Association for Retarded Children, 
Inc. 

1972 College Royal des Medecins et 
Chirurgiens du Canada 

1972 Royal College of Psychiatrists 


Titre 

Membre 

Membre 

Membre 

Membre 

Membre 

Membre du Comite de $ 
cialit£ en psychiatrii 

Membre 

Membre 

Membre 

Membre 

Membre du Conseil d'a 
ministration 

Membre 

Award of Honor 

Fellow 
Membre 

. . ./5 


5 


SOCIETES SAVANTES ET COMITES: 


Date 


Organisme 


litre 


State of New York, Dept of Mental 
Hygiene 

State of New York United Cerebral 
Palsy 

1973 American Academy of Psychiatry S 
Law 

College Royal des Medecins et Chi- 
rurgiens du Canada 

Societe Medico-psychologique 

Association du Quebec pour les 
Deficients Mentaux 
1982 American Psych. Association 
1984 Canadian Psychiatric Assoc iaion 
PUBLICATIONS : 


Meritorious service 
citation 

Meritorious service 
award 

Membre 


Membre du jury franqais 
aux examens de sp^cialite 
en psychiatrie 

Membre Associ£ Stranger 

Membre du Conseil d' adminis- 
tration 
Fellow 

President elect 


I- ARTICLES: 


F. GRUNBERG 


Les correlations psychosomatiques en pnysio-pathologie generale 


(These - Faculte de medecine de Montpellier - Decembre 1952) 

PRIX DE THESE - MONTPELLIER MEDICALE 1954. 

C. GROS, B. VLAHOVITCH, F. GRUNBERG 

L'Hemispherectomie dans 1 'Hemiphlegie infantile 

(La semaine des hopitaux, annales de chirurgie) 29e ann£e, 
no 2 - 18 fevrier 1953. 

C. GROS, J. CADILHAC , B. VLAHOVITCH, F. GRUNBERG 

La sympathectomie pre-ganglionnaire dans les syndromes dou- 
loureux post-traumatiqu« du membre superieur 

(Montpellier Chirurgicale I, 1-1952 pp. 55-59) 

F. GRUNBERG, D.A. POND 

Conduct Disorders in epileptic children 


. . ./6 


6 


PUBLICATIONS (suite) 

(J. of Neurology, Neurosurgery and Psychiatry, 1957 , 20 , 65 .) 
F. GRUNBERG, T.F. WARD 

Geriatric patients in a general hospital psychiatric unit 
(Canad Med Ass J 81 360-4, 1 septembre 1959) 

F. GRUNBERG 

A community mental health clinic 
(Canad Nurse 56 209.13, March 1960) 

HANLEY, F.W. , GRUNBERG, F. 

Reflections on the doctor-patient relationship 
(Canad Med Ass J 86 1002-4, 2 June 1962) 

XELM, H., GRUNBERG, F. , HALL, R.W. 

A reexamination of the Hof f er-Ormond diagnostic test 

(Int J Neuropsych 1:307, 12 Aug 1965) 

LAFAVE, H.G., HERJANIC, H., GRUNBERG, F. 

One year follow-up of 67 chronic psychiatric patients 

(Canad Psych Ass J 11: 205-11, June 1966) 

LAFAVE, H.G., STEWARD, A.P., GRUNBERG, F. , et al. 

The Weyburn experience: reducing intake as a factor in 

phasing out a large mental hospital 

(Compr psychiat 8: 239-48, Aug 1967) 

CASSELL, W.A., GRUNBERG, F. , FRASER, H.N. 

The discharged chronic patient's utilization of health 
resources: a preliminary report 

(Canad Psych Ass J 13:23.9, Feb 1968) 

STEWART, A., LAFAVE, H.G., GRUNBERG, F. , et al. 

Problems in phasing out a large public psychiatric hospital 

(Amer J Psychiat 125: 82-3, 1968) 


. . ./7 


7 


PUBLICATIONS (SUITE) : 

CASSELL, W.A. , SMITH, C.M., GRUN3ERG , F., et al. 

Comparing costs of Hospital and Community Care 
(Hosp £ Com Psychiat 23-7, 1972) 

GRUNBERG, F. 

Who Lives and Dies? 

(The New York Times, Op Ed Page, April 22, 1974) 

GP.UN3ERG , F. , LAFAVE , K . 

La fin de l'asile 

(Information psychiatrique , vol. 50, no 5, mai 1974) 

GRUNBERG, F. 

Les grandes contestations juridiques de 1 ' antipsychiatrie 
aux Etats-Unis 

(Union Medicale du Canada, Tome 105, 935-941, juin 1976) 

F. GRUNBERG, BURTON I. KLINGER AND BARBARA GRUMET 
Homicide and Deinstitutionalization of the Mentally 111 
(Am J Psychiatry 134:6, June 1977) 

J. FUENTES BIGGI, U. GOETZL, F. GRUNBERG 

Psicosis toxica de larga duraction por phencyclidina 

(Archivos de Neurobiol, 40, 2 (117-122), 1977. 

11 - 

F. GRUNBERG, UGO GOETZL, BERNARD BERKOWITZ 

Lithium Carbonate, in the Management of Hyperactive 
Aggressive Behavior of the Mentally Retarded 

Comprehensive psychiatry Nov. /Dec. 1977, vol. 18 

F. GRUNBERG, BURTON, I. KLINGER, BARBARA R. GRUMET 

Homicide and community-based psychiatry. Journal of Nervous 
and Mental Disease, 1978, vcl. 166, no 12 

III - LIVRES : 

PSYCHIATRY - A concise textbook for primary care practice 
Ed. Alan M. Kraft, m.d. - Arco Publishing Co. New York 1977 

Chapitres rediges: 

- SITUATIONAL STRESS, UGO GOETZL and FREDERIC GRUNBERG 
pp. 39-47 


. . ./8 


8 


III - LIVRES (suite) : 

- PERSONALITY DISORDERS, FREDERIC GRUNBERG, M.D. 
pp. 62-70 

- MENTAL RETARDATION, FREDERIC GRUNBERG, M.D. 
pp. 177-186 

MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES - IX 
Ed. Joseph Wortis, m.d. Brunner/Mazel Publishers New York, 

1977 

Chapitre redige: 

- WILLOWBROOK: A VIEW FROM THE TOP, FREDERIC GRUNBERG, M.D. 

pp. 46-52 

PSYCHIATRIE CLINIQUE: APPROCHE CONTEMPORAINE 

Pierre Lalonde et Frederic Grunberg , GaStan Morin, editeur, 
Chicoutimi 1980. 

IV - COMMUNICATIONS: 

Lafon, R. , Gros, B. , LaBauge , R., Paleirac, R. , Grunberg, F. 

La Cisternographie 
(Soc. d'electro-radiologie Medicale du Littoral Mediterraneen, 
Nice. 26-27: 1: 1952) 

Euziere, G., Gros, C., La Bauge , R. , Cadihlac, J., Grunberg, F., 
Vlanovitch, B. 

Les formes psychiatriques des tumeurs cerebrales 
(Soc. Sciences Medicales et Biologiques de Montpellier) 

Stance du 14 mars 1952 

Lafon, R. , Gros, C., Minvielle, J., Billet, B., Grunberg, F., 
Vlahovitch, B . 

Eosinophilie sanguine et traitement psychiatrique 
(Soc. Sciences Medicales et Biologiques de Montpellier) 

Seance du 25 avril 1952 

Vidal, J., Lafon, R. , LaBauge, R. , Minvielle, J., Barjon, P., 
Grunberg, F. 

Deux cas d' intoxication aiguS volontaire par compose amphetamini 
(Soc. Sciences Medicales et Biologiques de Montpellier) 

Stance du 3 mai 1952 


. . ./9 


9 


IV - COMMUNICATIONS (suite) : 

Gros, C. , Lafon, R. , LaBauge, R. , Cadilhac, J., Minvielle, J. , 
Grunberg, F. 

Recidive de meningiome temporo-occipital gauche d' expression 
psychiatrique predominante 

(Soc. Sciences Medicales et Biologiques de Montpellier) 

Seance du 3 mai 1952 

Gros, C., Cazaban, R., Cadihlac, J., Vla'novitch, B. , Grunberg, F. 

Ramollissement calcarinien chez un syphilitique . Etude clinique 
et anatomique. 

(Soc. Sciences Medicales et Biologiques de Montpellier) 

Seance du 27 juin 1952 

Grunberg, F. , LaFave, H., et al. 

Reducing the population of a Mental Hospital 

Communication au Congres Annuel de 1 'Association des Psychiatres 
du Canada, Vancouvert, juin 1964 

Grunberg, F. 

Financial arrangements as they affect the distribution of 
Mental Health Services 

Communication a la Conference Nationale des Services de la 

Sante Mentale 

Ottawa, 7 janvier 1966 

Grunberg , F. 

Psychiatry and anti-psychiatry 

Grand Rounds, dept of psychiatry, Albany Medical College, 

Dec. 1973 

Grunberg, F. 

Reform of the Mental Health System Through Court Litigations: 

An American Experiment 

(Communication au Congres Annuel de 1 'Association des Psychiatres 
du Canada, Ottawa, septembre 1974) 

Grunberg, F. 

Legal Activism and Psychiatry 

Grand Rounds at Allen Memorial Institute, McGill University, 

10 avril 1974 


. . ./10 


0 


IV - COMMUNICATIONS (suite) ; 

Grunberg , F . 

Homicide and Mental Illness 

Grand Rounds, Dept of Psychiatry, Albany Medical College, 

28 septembre 1976 

Grunberg, F. , Klinger, 5., Grume t , S. 

Homicide and the Deinstitutionalization of the Mentally 111 
Communication a l'assemblee annuelle de 1* American 
Academy of Psychiatry and Law, San Francisco, 2 5 octobre 19' 

Grunberg , F. 

Ethical Considerations on the Tarasoff Decision: Should 

Therapists Warn the Potential Victims of their Patients? 
Symposium on Ethics in Medicine, Albany Medical College, 
January 13-15, 1976 

Grunberg, F. 

Le patient qui refuse de se soumettre a un examen psychiatric 
Communication au Congres Annuel de 1' Association des Psychk 
du Quebec, Trois-Rivieres , 7 juin 1979. 


. . . annexe 


FG/da 

le 9 septembre 1980. 
Revise le 19 mars 1982. 



t 

r 

I 


Annexe 


- 11 - 

PUBLICATIONS ET COMMUNICATIONS: 


Grunberg, F. L'angoisse et l'insomnie. Communication 
presentee au Symposium de 1 'Association des pharmaciens 
du Quebec, Quebec, 11 octobre 1981. 

Grunberg, F. Le psychiatre dans les ann§es 80. Communication 
presentee dans le cadre du centenaire du centre hospitalier 
Douglas, Montreal, 25-26 novembre 1981. 

Grunberg, F. Les diffSrentes ecoles de pens§e psychia- 
trique. Presentee aux membres du dSpartement de m^decine 
g£n6rale, hopital Louis-H. Lafontaine, 14 janvier 1982. 

Grunberg, F. Pourquoi les femmes sont-elles tenement 
plus d#prim§es que les hommes? Presentee au personnel 
medical et para-medical de 1' hopital Louis-H. Lafontaine, 

10 fevrier 1982. 

Grunberg, F. et coll. Le suicide "Gu§rir le suicide?" 

Presentee dans le cadre d'Actuelles a la radio CBF-FM, 

29 janvier 1982 

Grunberg, F. Aspects pratiques du traitement des depres- 
sions en pr£sentant 1' usage des divers medicaments anti- 
depresseurs et les autres modalites de traitement biologique, 
tel que 1' electrochoc . II a aussi examine les di verses in- 
terventions d'orcre psychologique et sociale. Universite 
de Montreal, Faculte de 1' education permanente - Les Belles 
Soirees" 10 fevrier 1982. 

Grunberg, F. Perspective on the care of the longer-term 
mentally ill an overview statement. Association Canadienne 
pour la Sante Mentale, Toronto, 24-26 fevrier 1982. 

Grunberg, F. Le DSM III... ajoute-t-il a la precision du diagnos- 
tic Clinique. Colloque de mise 3 jour sur les nouveaux 
moyens diagnostiques en psychiatrie. Association des 
Psychiatres du Quebec, 26 mars 1982. 

Demontigny, C., Grunberg, F., Mayer, A., Desch3nes, J.-P. 

Lithium Induces Rapid Relief of Depression in Tricyclic An- 
tidepressant Drug Non-Responders. Brit. J. Psychiat 138, 

1981. 

Grunberg, F., Moamaf, N. Desmarais, G., Gagne, E. Examen 
psychiatrique sous ordonnance de cour 3 propos des patients qui 
refusent de se soumettre 3 un examen psychiatrique. Revue 
Canadienne de psychiatrie. Accepte pour publications 09-81 


- 7 - 

COMMUNICATIONS LORS DE CONGRF.S , SYMPOSIUMS, CONFK.nF.NCES , etc. 


Titre 


CondultzA dz manipulation 

2. - CondultzA deilrantzA 

3. - Introduction aux claAAlflca- 

tlonA dlagnoAtlquzA 

Introduction aux claAAlflcatloi 
dzA troublcA majcurA 
I moderatzur dc La journlz 
du A ympoAlum ) 

4. - "SocloLogij of PAychlatrlc 

Cart" 

5. - Prf diction dt La dangzroAlte 

tn pA ye Itla trie 

6. - Homicide zt pAiJchlatrlz 

communautalrz 

1.- Concept dz La pAiJchlatrlz mo- 
dzrnz, L volution hlAtorlquz, 
approchc actuzllz , milieu 
dz travail commz InA trumznt 
dz rladaptatlon, aza zffztA 
be.nl flquzA . 

PI flexion Aur la prediction 
dz la dangzroAlte zn 

pAyclilatrlz 

9 .- Violence et pAijchiatrle 


Occasion 

(congrAs, Association, etc.) 


Conference IntzrdlAclpllnalrz 
InAtltut Philippe Plnzt dz M tl 

Conference IntzrdlAclpllnalrz 
InAtltut Philippe Plnzt dz H tl 

SympoAlum Aur Iza pA ychoAZA 
fonctionnzllzA 

OrganlAl par I'A.P.Q. zn colla 
* boratlon avzc Iza departzmzntA 
dz pAiJchlatrlz dzA llnlv. 

Laval, HcGllt, Montreal zt 
Sherbrooke 
CSAA AZAAlon 
SaAkatchzuian Health, (I nlvzrAltij 
llosp. , SaAkatoon 

Echangz Francz-Quebzc 
HOpltal Chznzvlzr d Cretzll, 

France 

F.changz Francz-Quebzc 
HGpltal dz la Co tomblirz , 
Montpellier , France 

CongrzA - Aaa. dzA MedzclnA 
du Travail du Quebec 
Joume.z Aur Iz AtrzAA, I'alcool 
zt la maladlz pAijchlatrlquz 
cn milieu dz travail 

HOpltal Hotrz-Vamz , Montreal 
Conference IntzrdlAclpllnalrz 

Ildtel-Pieu de LIvIa , Quebec 

Reunion men Aue//.e cfeA 

c /i ^ a / A c A *1 u Q«a & l> v c. 

- 7 - 


Date 


l 91 S 
I 978 
10 - 79 


1980 

11-80 

I 2-80 

11-80 


2-81 


3-81 


Communication 

(a) (I caract&re 
sc lent if Ique 

(b) A caractAre 
de vulgar I snt Ion 


A 

A 

A 


A 

A 


l'ubl Ife 
(lu<lli|ucr par 
un X si an 
ret. rnuve ilans 
autre rubrlijuc 


.«.« ns rnNCRES. SYMPOSIUMS, CONKERRNCRS, etc. 


cnuu/io u(i uiieoec 




COMHUN ICAT1QM 3 L OUS nr. CO NCUR S, S Y HfOS I U MS , CON KFB RHCF- S . etc. 


10 .- 


11. - 

12 . - 


Tltre 


Animate.uK - jouKnle d 1 auto- 
€ valuation psychiatKique 
FKSAP- 1 V 

The futuKe o& the Mental llosp. 

Le patient qui Ke&use de 
se soumettKe & uh examen 
psychiatKique 


Occas Ion 

(congr&s, Association, etc.) 


APQ - JouKnfe d’ auto- Ivaluatioi 
[Association des PsychiatKes 
du Qulbec) 

HGpital Douglas . MontKlal 

CongKls annuel de l' Associatio 
des PsychiatKes du Quebec, 

TKois-RiviiKes 


Date 

Common 1 cat Ion 

(a) A carnct^rc 
aclent If l«|iie 

(b) A caractAre 

de vulgarism Jon 

rnbl I6e 

(lndl<|iier |»ar 
mi X al ne 
ret rou ve Jana 
outre rubrl(|«ie 

3-81 

A 


4-81 

A 


i 6-79 

A 



PUBLICATIONS (suite) 


1982 


Grunberg, F. Pourquoi les femmes sont-elles tenement 
plus deprimees que les hommes? Presentee au personnel 
de l'hopital Louis-H. Lafontaine dans le cadre du 
programme d ’ enseignement multidisciplinaire , 10 fevrier 
1982 

Grunberg, F. Classification des maladies mentales. 
Presentee aux membres du departement de medecine 
generale, hopital Louis-H. Lafontaine, 3 juin 1982. 

Grunberg, F. Chomage . Nouvelles TVA, Tele-metropole , 9 
juillet 1982 

Grunberg, F. "La crise de la quarantaine" . La Vie 
Quotidienne, Radio-Canada, 30 septembre 1982 


1983 

Grunberg, F. Conference presentee a Ottawa au Ottawa 
General Hospital. "A new approach to the problem of 
suicide". 26 janvier 1983 

Grunberg, F. Participation au debat sur la depression a 
1' emission Forum, Tele-metropole, 5 mars 1983 

Grunberg, F. Psychiatry grand rounds " The judiciary 
dimension in the hospitalization of psychiatric patients 
in Montreal", Centre hospitalier de St-Mary, 17 mars 1983 

Grunberg, F. Participation au debat sur les droits des 
malades mentaux a 1’ emission Forum, Tele-metropole, 19 
mars 1983 

Grunberg, F. Participation au symposium international 
sur la schizophrenie et sa famille, 22 et 23 septembre 
1983 

Grunberg, F. Preside une seance lors du symposium 
"Neurotransmetteurs Cerebraux et Psychiatrie" organise a 
1' intention des psychiatres cliniciens du Canada, Quebec, 
les 22 et 23 octobre 1983 

Grunberg, F. "The chronic mental patients: is there a 

future for them?" conference presentee a "Association of 
relatives and friends of the mentally and emotionally ill 


1 


Montreal Inc", Montreal, le 2 4 octobre 1983 

- Grunberg, F. Participation a une conference de formation 

medicale continue: Violence - prediction et implications 

legales, Centre hospitalier Douglas, le 8 decembre 1983 

1984 

- Grunberg, F. Symposium: "Benzodiazepine Therapy Today", 

Four Seasons Hotel, Toronto, Ont. - "Benzodiazepine Side 
Effects (Rebound Anxiety and Insomnia, Accumulation, 
Amnesia), 16 avril 1984 

- Grunberg, F. Dans le cadre d'une journee d ' inf ormation 

"Les patients sous ordonnance du Lieutenant-gouverneur : 
aspects cliniques et legaux" il a presente: Reflexion 

d'un psychiatre siegeant a la Commission d'examen, Hotel 
Reine-Elizabeth, 19 octobre 1984 

1985 

- Grunberg, F. "Legislation et le reseau des services 
psychiatriques" Cours en sante mentale. Programme de la 
Maitrise en Sante communautaire du departement de 
medecine sociale et preventive, Universite de Montreal, 

30 janvier 1985 

- Grunberg, F. "La judiciarisation des maladies mentales" 
presentee au Congres de 1 ' Association des hopitaux du 
Quebec les 14 et 15 mars 1985 

- Grunberg, F. Participation au colloque sur "Les aspects 
medico-legaux dans la pratique psychiatrique courante", 

Le titre de sa conference: "Logique legale versus 

logique psychiatrique". Colloque organise de concert 
avec l'Institut Philippe Pinel et l'hopital Louis-H. 
Lafontaine, 26 et 27 avril 1985 

- Grunberg, F. Participation au congres de l'A.P.Q. II a 
presente "Le suicide et la maladie mentale", les 14 et 15 
juin 1985 


FG/da 

le 5 juillet 1985 



UNIVERSITY OF SASKATCHEWAN 



MOCINE 


SASKATOON. CANAOA 
S7NOWO 


Ref File No 


January 8, 1986 


Mr. George T.H. Cooper 
P.0. Box 730 
1673 Bedford Row 
Hal i fax ^ N.S. 


Dear Mr. Cooper: 


This letter is in response to telephone discussions I had with 
jou in late November , the substance of which was set down in your letter 
of November 26, 1985. In this letter you set out the questions you wished 
answered regarding the Allan Memorial Institute, and specifically the 
practice of its late Head, Dr. Ewen Cameron. 


In addressing your questions, I should record certain caveats I 
feel must be taken into consider at ion by anyone when reading my opinions 
;>en the specific issues being addressed. 

In the first place, I did not know Dr. Cameron personally. 

Although I met him on one occasion socially I did not have the opportunity 
to hear him at scientific meetings or professional gatherings. As a 
result, any observations I make are based solely on those papers of Dr. 

'a that I was able to obtain. 


Secondly, my opinion of Dr. Cameron's research competence is 
on a small sample of the total number of papers published during the 
se of his career. The sample did include, however, papers relating 
his research into "Psychic Driving" and "Depatterning" . It would 
»ar that these were two major areas of interest to him during the 
latter part of his career. 


Finally, my opinions regarding "the directions in which 
psychiatric research was heading at the time" , and particularly the status 
of medical ethics at the time, are based to seme extent on personal 
[experience, but to a larger degree, on my evaluation of the research 
papers that were published in the three major national psychiatric 
publications, namely, the Journal of the Canadian Psychiatric Association, 
the Journal of the American Psychiatric Association, and the Journal of 
Mental Science (subsequently to become the British Journal of Psychiatry) . 
I chose as my criterion year 1962 as this was the year in which Dr. 
[Cameron's paper on "The Depatterning Treatment of Schizophrenia" was 
published in "Comprehensive Psychiatry" (April 1962) . 


2 


In xny opinion, in order to understand the level of development 
of psychiatric theory and practice in the 1960's, one must view it against 
the background of developments in medicine as a whole. The tremendous 
growth in clinical and basic medical research which occurred following 
World War II was stimulated not only by the development of new 
technologies, tut also by the wedding of clinical medicine with 
biostatistics. Ihis development led to increased rigour in medical 
research, which in turn impacted on all areas of medicine, including 
Psychiatry. There was, however, a lag in the development of psychiatric 
research as was noted in the introduction to Report #42 (1959) of the 
Group for the Advancement of Psychiatry. In this report it was stated "in 
comparison with other fields, psychiatry does not have the strong research 
tradition oriented to systematic emperical investigation of important 
problems. At the same time, we do have a great need for immediately 
applicable working formulations which offer seme guide to treatment. 

These conditions favor quick and often premature closure with plausible 
hypotheses provided by respected authorities. In time, it may be easily 
forgotten that they are unverified hypotheses and they come to be treated 
as established fact. It is however true, in Psychiatry as in other 
scientific fields, that authority is no substitute for evidence - ! 7 * (the 
underlining is mine) . I think this latter statement is particularly 
applicable to the work of Dr. Cameron. 

The review of the indexed psychiatric journals of 1962 would 
indicate to me a movement towards greater precision in the diagnosis and 
classification of psychiatric disorder; greater interest in population 
studies of patients with particular disease entities; increasing interest 
in the search for physiological correlates of behaviour and increased 
interest in the evaluation of treatments. The general thrust represented, 
in my mind, a departure from the period that immediately followed World 
War II when psychoanalytic and socio-cultural theories of behaviour were 
in the forefront of psychiatry and biological psychiatry was relegated to 
the background. Unquestionably the introduction of tranquillizers and 
subsequently the antidepressants sparked a renewed interest in the 
biological basis of behaviour and brought psychiatry and the neurological 
sciences closer together. However, the transfer of the research 
methodologies of the so-called hard sciences (e.g. Biochemistry, 
Neurophysiology, etc.) to psychiatric research was confounded by numerous 
difficulties, not the least of which was the lack of generally accepted 
classification of mental disorder. Indeed, this inability to agree upon 
diagnostic criteri4?f was to present a major obstacle to the generation and 
sharing of new information about psychiatric illness. Undoubtedly this 
contributed to the lag in the development of psychiatric research. 

In reviewing these journals and a number of textbooks of the 
day, it was cibvicus that psychiatry in the late 1950 ' s and ' 60's continued 
to use treatments which had historical but not scientific legitimacy. 

This is amply illustrated in an article in the American Psychiatric 
Association Journal of 1962 by an emminent British Psychiatrist who 
expounded on the significant contributions to patient care provided by 
such treatments as labotany, ccma insulin, amphetamines and barbiturates. 
Within a few years, of course, all of these treatments had fallen into 
disrepute either because of the lack of evidence of effectiveness or 


3 




because the risks attendant upon their use far outweighed what therapeutic 
value (if any) was derived frcro their use. Even electroconvulsive 
therapy, then in wide use and currently still considered an effective 
treatment for a limited number of conditions, was generally accepted even 
in the absence of any scientifically valid measure of its effectiveness. 
Indeed, Kendel, in a recent publication, indicated that of all the 
countless studies involving the use of ECT, only ten met his criteria as 
being truly "scientific". 

In the late 1950's and early ' 60's psychiatric research as we 
know it today, was in its infancy. There were relatively few centers with 
established research departments or programs. Althcwgh there wre 
increasing numbers of reports on new treatments, the quality of these 
studies was distressingly lew. This was particularly true of clinical 
trials of new drugs. The Allan Memorial Institute was one of the few 
North American Institutions that was committed to the development of both 
psychiatric research and psychiatric researchers. It was acknowledged to 
be the leading academic psychiatric centre in Canada. It also enjoyed an 
enviable reputation in the United States and abroad. Certainly much, if 
not most, of the credit for its early reputation belonged to Dr. Ewen 
Cameron. Dr. Cameron was recognized by his peers as being one of the 
leaders, if not the leader, of Canadian psychiatry. His reputation was 
built on his early achievement in organizing psychiatric services in 
Brandon, Manitoba during the 1930's, and his development of a teaching and 
research program at the Allan Memorial Institute in the 1940 's and 1950 's. 
He was able to attract a coterie of bright young psychiatrists, many of 
whcm subsequently became heads of academic departments in North America or 
were to make their name in fields of teaching or research. Cameron had an 
impeccable background. Cameron received his M.B. at the University of 
Glasgow and in 1925 received his Diploma in Psychological Medicine from 
the University of London. In 1936 he received his M.D. "with distinction" 
fron the University of Glasgow. In 1937 he was elected Fellcw of the 
American Psychiatric Association. Insofar as his psychiatric training was 
concerned, he received his initial training at the University of London in 
1925 receiving his DIM, and in 1926 was a Henderson Research Fellcw at the 
Fhipps clinic in Baltimore. He also spent seme time at the Burghoelzli 
Clinic. This was an internationally renowned psychiatric training centre. 
Fran 1929 to 1936 he was the Director of the Provincial Mental Hospital in 
Brandon. From 1936 to 1938 he was a Resident Director of Research at 
Worcester State Hospital, and from 1938 to 1943 he was Professor of 
Neurology and Psychiatry at the Albany Medical College in New York. In 
1943 he was appointed Professor and Head of the Department of Psychiatry, 
University of McGill. In a biographical sketch written by Dr. Gregory 
Zilboorg in the American Psychiatric Association Journal, 1953, it was 
noted that by that time he had authored 80 articles and "several books". 

A review of his curriculum vitae reveals that he quickly climbed the 
academic ladder. His overall position in the profession is attested to by 
the fact that he was elected to head three prestigious psychiatric 
organizations; the Canadian Psychiatric Association, the American 
Psychiatric Association, and the World Psychiatric Association. In short, 
whatever his shortcomings as a person, he obviously was a credible figure 
professionally . 


It would appear that Cameron had an interest in both Neurology 


4 


and Psychiatry. This was not uncommon in those days, as many 
psychiatrists had dual training. Although not a psychoanalyst, he, like 
many of his contemporaries, borrowed freely from psychoanalytic concepts, 
such as the role of the unconscious, intrapsychic conflict, etc. Lite 
many of his contemporaries, his theorizing reflected both psychoanalytic 
and biological interests. Certainly his work in depatterning and psychic 
driving would reflect this orientation. Cameron was not alone in this, 
however, as Lawrence KUbie and the renowned Walter Penfield co-operated in 
efforts at finding a structural basis for psychoanalytic concepts. 

In evaluating Cameron's work in the 1950's and early 1960 's, it 
is important to look at the relationship that existed between the patient, 
the family and the physician (psychiatrist) . Although I have no hard 
evidence to support this, it is my impression that the public acceptance 
of physicians at that time was high. Again, it is an impression, not a 
fact, that the psychiatrist was held in particular awe by the patient 
and/or their family (although not by the public) . I think this 
relationship derived from the sense of mystery and ignorance that 
surrounded mental disorders. That the psychiatrist, through methods 
unfamiliar to them (unlike the general practitioner) could make sense out 
of what frequently was an irrational situation, served only to enhance his 
position. Frequently the family abdicated its responsibility for 
determining what was best for the patient. They were quite happy to 
transfer this responsibility to the psychiatrist or the medical 
superintendent. It has been my experience that by and large, 
psychiatrists honoured this trust and that their treatment of patients was 
determined by commitment in what they thought was best for the patient. 
Unfortunately , events would indicate that their idea of what was "best for 
the patient" was based on inadequate theory and scientific evidence. 
Unfortunately, confronted with enormous demands for their services and a 
paucity of effective treatments, the psychiatrist, in the 1950 's and early 
'60's, frequently resorted to new treatments that had not yet demonstrated 
(scientifically) their effectiveness but held out the promise of "cure". 

In my opinion, this was quite understandable. 

In spite of the advent of tranquillizers, Schizophrenia remained 
an enigma to the psychiatrists of the 1950 's and 1960 's. It may explain 
why Dr. Cameron, mindful of his leadership goal, would choose to tackle 
this difficult and perplexing problem. In reviewing the past experience 
with the treatment of schizophrenics, he noted the distressingly high rate 
of relapse. He surmised that this was due to one of two causes; either 
inadequate initial treatment or lack of appropriate after-care. He 
obviously felt that schizophrenics should be given intensive treatment 
initially. He believed that schizophrenia was the result of learned 
maladaptive thinking. His object, therefore, was to "depattem" the 
patient's thought processes through the use of three techniques: 1) 

massive electroconvulsive therapy, 2) continuous sleep and 3) maintenance 
elecro therapy. None of these techniques was new. Massive ECT had been 
used (sparingly) since 1946 and continuous sleep treatment had enjoyed a 
vogue seme ten to fifteen years previously. Neither were, at the time of 
Cameron's experiments in the 1960 's, generally in use and one might 
conclude from this that they were not generally accepted. Maintenance 
ECT, however, while not universally accepted, did have a modest 
following, but was soon to be replaced by major tranquillizers and 


5 


antidepressants. Electroocnvulsive Therapy itself was widely used and 
generally accepted as being effective in a variety of psychiatric 
disorders. It was generally given three times a week until such time as 
there was a significant improvement in the patient's clinical state. On 
the whole, it would mean seme 8 to 12 treatments, (not infrequently less 
and occasionally more) . The introduction of muscle relaxants in ECT 
enabled increasing numbers of patients to receive this treatment, who had 
previously been excluded on medical grounds. ECT continues to be used in 
psychiatric treatment, albeit for a restricted group of disorders. 

In summary then, the treatment techniques used by Cameron in his 
depatterning experiments had previously been used in psychiatry. Although 
by 1962 I would think that only maintenance ECT still enjoyed any vogue 

whatsoever. 


During the late 1950 's and early '60's great changes took place 
in the care of the mentally ill. Simultaneous with the introduction of 
new and effective chemotherapy, there was recognition of the possible 
harmful effects of long-term hospitalization. This raised the expectation 
among psychiatric professionals of finding new and effective methods for- 
reducing the length of stay, and indeed, even preventing the admission of 
patients suffering from psychiatric disorder. The acquisition of 
effective treatment methods had a significant impact on the morale of 
people working in mental hospitals. They saw their facility changing from 
that of a warehouse to that of an active treatment and rehabilitation 
centre. The demand for newer and more effective drugs stimulated a spate 
of drug trials. However, clinical trials, using psychiatric patients and 
particularly outpatients, were found to be fraught with difficulties. It 
was difficult to collect significant number of outpatients to draw 
statistically Veil id conclusions. In addition, psychiatric patients were 
notoriously non-ccsnpliant, making it difficult to determine whether they 
were taking their medication or not. Psychiatric outpatients were also 
inclined to drop cut of treatment studies because of lack of motivation, 
secondary to the disease process. It was understandable then, that faced 
on the one hand with the problems of designing and implementing 
scientifically rigorous clinical trials on an outpatient basis, and on the 
other hand, with the need to find answers to pressing clinical problems, 
many researchers turned to the mental hospitals and psychiatric units for 
subjects of clinical research. By using inpatients of large provincial 
hospitals the methodological problems of patient numbers, compliance, 
attrition rates, were significantly reduced. 

Patient advocacy and patient rights were not significant issues 
in psychiatric practice in the late 1950's and early 1960 's. Mental 
health legislation, while providing the opportunity for the appeal of 
commitment procedures, did not incorporate patient advocacy within 
Provincial Mental Health Acts. The patient and/or their family were left 
to their own devices (perhaps with the assistance of their lawyer) in 
dealing with conflicts between themselves and hospital authorities. This 
placed many families in a difficult situation, as they were frequently 
totally dependent upon the institution for care of their family member. 

For this reason, "consent for treatment", either by or on behalf of the 
patient could be open to question as to whether or not it was truly freely 
given. 


6 


Dr. Cameron's research activities would seem, in my opinion, to 
reflect the standards of his day. While his research methodology as 
presented in his papers was seriously flawed, it was not significantly 
worse than that of others appearing in the literature at that time. 
Psychiatric reports of the time frequently were lacking in specific and 
precise diagnostic criteria and standardized outcome measures. As an 
illustration of this point, I refer you back to Kendel's evaluation of 
research done an ECT. 

The topic of Cameron's research (e.g. schizophrenia) was an 
appropriate one as it represented one of the major clinical problems 
facing psychiatrists of the day. His belief that prompt and adequate 
tratment, and a well monitored after-care program as essential ingredients] 
to reducing the degree of disability in schizophrenics would appear 
reasonable. His method of achieving this, however, I think is seriously 
open to question because of the use of two techniques which carried a not 
inconsiderable risk and which hitherto had not been established as being 
effective. 


In commenting on the ethics of psychiatric research, past and 
current, one must first of all review developments in all research 
involving use of human subjects. Certainly the revelations of the abuse 
of human subjects in so-called medical research carried out in Germany and 
Japan during the second world war sensitized the medical and scientific 
communities to the need for a universal code of ethics. The evolution of 
this code is described in the Medical Research Council of Canada Report #6 
(1978), "Ethics in Human Experimentation". The first set of guidelines 
would appear to have been the Nuremkurg Declaration, which of course arose 
out of the proceedings involving war crimes trials in the late *40's. 
Subsequent to this, the Declaration of Helsinki (1964 and 1974) was 
adopted by the World Medical Association as a set of guidelines governing 
human experimentation. Finally, a working group established in 1977 by 
the Medical Research Council of Canada proposed guidelines applicable to 
research carried on in Canadian institutions by Canadian researchers. 

I will not discuss MRC Report in detail as it is readily 
available to you. I would point cut only that this report established 
that the Aina qua non for all research involving human subjects is that it 
be scientifically valid. "Without scientific merit, placing human beings 
at risk to perform an experiment cannot ethically be justified". The 
report goes on to discuss a variety of issues such as "informed consent", 
the lose of "captive" subjects, the use of one's own patients in research, 
and the ethical responsibilities of the investigator, the institution and 
the granting agency. In addition to setting out ethical guidelines the 
report also proposes procedures for implementation, such as the 
establishment of institutional ethics committees, and the documentation in 
grant applications to the Medical Research Council of the fact that 
ethical issues have been considered and resolved to the satisfaction of 
the investigator and the institutional ethics committee. It is my 
opinion, based primarily on my experience in the College of Medicine, 
University of Saskatchewan, that these guidelines are adhered to and have 
resulted in increased sensitivity to ethical issues related not just to 
medical research but to patient care in general. In my opinion, had these 


7 


guidelines been in place at the time of Cameron's work in the Allan 
Memorial, I have serious doubts as to whether he would have been able to 
proceed with his work. Certainly not in the fashion described in his 
papers. 


It is difficult to compare ethical practices of the present with 
those in the past. Certainly this is especially true in research. The 
major source of information we have about research are the reports 
published in scientific journals. Unfortunately, the issue of hew 
patients are "recruited" into research programs is rarely addressed. 

True, there are some papers, notably those in psychology, where the use of 
"volunteers" is specifically stated. But even here one must raise a note 
of caution as the use of "volunteers" does not necessarily guarantee that 
such issues as informed consent have been satisfactorily addressed, (see 
Halushka v the University of Saskatchewan, Dominion Law Report 53 (20, 
436-466 (1965) . Because of the above, I feel that I can only make a 
general statement about the ethical standards of medical and psychiatric 
research. I believe it is now quite clearly recognized that the 
responsibility for ensuring the quality (both from scientific and ethical 
standpoints) of research involving human beings lies jointly with the 
investigator, the institution in which he works, and the granting agency 
that supports his research activity. In my opinion, all three could and 
would be currently held accountable for research projects that do not meet 
the current standards of research practice in Canada. We have arrived at 
this point through gradual evoluation as witness the report of the Medical 
Research Council's working group. Certainly the case of Halushka v 
University of Saskatchewan would indicate that the present ethical 
standards were not universally applied in 1964. For this reason I have 
seme question as to whether these obligations were as clearly identified 
or as clearly acknowledged by researchers, institutions or granting 
agencies in the 1950 's and early 1960 's. I think this was particularly 
true in psychiatric research which admittedly lacked the tradition of 
research in other areas in medicine. This may partially explain the 
apparent indifference of Cameron and others, to what are now held to be 
essential safeguards of patients' rights. 

I hope that this addresses most of the issues identified in your 
letter of November 26. 


Yours truly, 



I.M. McDonald, M.D. , 
Dean of Medicine. 



April 27, 1982 


I 


2 


CURRICULUM VITAE 
FOR 

McOONALD, Ian Maclaren 
Department of Psychiatry 

1. PERSONAL: 

8orn May 20, 1928 
Employee No. 33885 

2. ACADEMIC CREDENTIALS: 

M.D., University of Manitoba, 1953, College of Medicine 

3. OTHER CREDENTIALS: 

F.R.C.P.(C), Royal College of Physicians and Surgeons of Canada, 
Psychiatry, 1972 

A. APPOINTMENT(S) AND PROMOTIONS (U OF S): 

Assistant Professor of Psychiatry, Without Term, 1958-62, College of 
Medicine 

Associate Professor of Psychiatry, Tenured, 1962, College of Medicine 
Professor of Psychiatry, Tenured, 1967, College of Medicine 
Head, Department of Psychiatry, Tenured, 1971 to present. College of 
Medicine 

5. ASSOCIATE MEMBERSHIPS: 

Nil 


6. LEAVES: 

Leave, Edinburgh, Scotland, 1967 to 1968 

7. HONOURS (MEDALS, FELLOWSHIPS, PRIZES): 


8 . 


Fellow, American Psychiatric Association 
Post-Doctoral Fellow, Edinburgh University, 1967 to 1968 

PREVIOUS POSITIONS RELEVANT TO U OF S EMPLOYMENT: 



Instructor in Psychiatry, University of Colorado, School of Medicine, 
1957 to 1958 

Resident (Chief), Colorado Psychopathic Hospital, University of 
Colorado, 1956 to 1957 

Fellow in Neurology, University Hospital, University of Saskatchewan, 


9. T 


10 . 


11 . 


12 . 


McDONALD, Ian Maclaren 


l 


Me DO 


2 


April 27, 1982 


1955 to 1956 

Resident, Monroe Wing, Regina General Hospital, 195 4 * to 1955 
Resident, Crease Clinic, Essondale, British Columbia, 1953 to 195* 

9. TEACHING RECORD: 

Undergraduate Education: 

MMSI - 2 to 3 mornings per year 

Med. II - 30 IB - Lectures (1 hr x 13); Tutor In small groups (2 hrs x 
13) 

Med II - 350A - 2 hr seminar 

Med III A IV - 3 hrs/week (1 student for each 8-week period) 

Med V - JURSI Seminars, Supervision of JURSI Ward Responsibilities 
and Outpatient Consultations 

Postgraduate Education: 

Seminar Teaching 

Supervision of Inpatient and Outpatient Interviews and Treatment 
Home Care Conferences: 

- Involves meeting with Home Care Nurses for 1 1/2 hrs every 3 months 
to discuss caseload (also on p.r.n. basis) 

10. THESES SUPERVISED: 

Nil 

11. BOOKS, CHAPTERS IN BOOKS, EXPOSITORY ANO REVIEW ARTICLES: 

nil 

12. PAPERS IN REFEREED JOURNALS: 

PU6LISHE0: 

I.M. McDonald, 1971. Diagnostic Significance of Physical Signs Produced 
Ouring E.C.T. Canadian Medical Association Journal , 10k , 311 —3 12. 

I.M. McDonald, 1970. Psychiatry and the Law. Laval Medical Journal , 
775-783. 

D.G. McKerracher, C.M. Smith, F.E. Coburn and I.M. McDonald, 1966. 
General Practice Psychiatry. College of General Practice of Canada 
Journal , 12 , 38—% 1 . 

0. G. McKerracher, C.M. Smith, F.E. Coburn and I.M. McDonald, 1965. 

General Practice Psychiatry. The Lancet , November, 1005-1007. 

1. M. McDonald and M. Perkins, 1966. A Controlled Comparison of 

Amitriptyline and Electro-Convulsive Therapy in the Treatment of 
Depression. American Journal of Psychiatry , 22 , p. 1k27, June. 

ACCEPTED: 


NcDONALD, Ian Maclaren 


April 27, 1982 


) 


A 


Nil 

13. PAPERS IN NON-REFEREED JOURNALS: 

PUBLISHED: 

Nil 

ACCEPTEO: 

Nl I 

14. INVITED PAPERS IN PUBLISHED CONFERENCE PROCEEDINGS AND ABSTRACTS: 

Nil 

15. CONTRIBUTED PAPERS IN PUBLISHED CONFERENCE PROCEEDINGS AND ABSTRACTS: 

Nil 

16. TECHNICAL REPORTS RELEVANT TO ACAOEHIC FIELD: 

Nil 

17. BOOK REVIEWS: 

Nil 

18. INVITED LECTURES OUTSIDE U OF S AND INVITED CONFERENCE PRESENTATIONS: 

I.M. McDonald, 1979. Community Psychiatry. November 25, Yellowknife, 
North West Territories. 

I.M. McDonald, 1978. Confidentiality In Psychiatry. Canadian 
Psychiatric Association, Halifax, Nova Scotia. 

I.M. McDonald, 1977. Psychiatry and the Law 

I.M. McDonald, 1977. Suicide 

I.M. McDonald, 1988. Student Mental Health, University of Calgary, 

Calgary, Alberta. 

I.M. McDonald, 1988. The Medical Aspects of Privilege, University of 
Calgary, Calgary, Alberta. 

19. PRESENTATIONS AT CONFERENCES (Non- Invi ted) : 

Nil 

20. PATENTS GRANTED OR PENDING: 

Nil 

McDONALO, Ian Maclaren 


21. I 

22 . - 
23. 


Me O' 




April 27, 1982 


21. RESEARCH GRANT INFORMATION: 

Nil 

22. ARTISTIC EXHIBITIONS OR PERFORMANCES: 

Nil 

2J . PROFESSIONAL PRACTICE: 

Administrative Responsibilities: 

Clinical Department Heads in the College of Medicine traditionally have 
dual responsibilities both as Heads of Academic Departments and Heads 
of Clinical Departments of University Hospital. As such, they are 
responsible to two governing Boards; namely those of the University 
of Saskatchewan and University Hospital. However, Psychiatry has a 
third line of accountab 1 1 i ty and that Is to the Minister of Health. 

In that the Clinical Department is designated as a 'facility' under 
the Mental Health Act and the Department Head is designated as 
Medical Of f leer- In-Charge, he Is by law, accountable to the Minister 
of Health to ensure that the regulations and provisions of the Mental 
Health Act are carried out in accordance with the law. In Saskatoon 
an anomalous situation exists in that the Head of the Department of 
Psychiatry at University Hospital Is also Medical Off icer-in-Charge 
for the two other designated facilities (the Psychiatric Ward at City 
Hospital and for the Regional Psychiatric Centre). In fact, then, 
the Head of the Department of Psychiatry Is responsible for the 
quality of a 1 1 inpatient care in the Saskatoon catchment area. This 
includes the 25^,000 population in the Saskatoon Mental Health Region 
as well as those inmates of the Federal and Provincial Correctional 
systems who may be treated at the Regional Psychiatric Centre. The 
duties of the Medical Of f icer- In-Charge entail the monitoring of all 
clinical activities in these centres with particular emphasis on 
those involving treatment of involuntary patients. It should be 
noted that in this province this function is normally carried out by 
a Regional Director in the Psychiatric Services Branch. However, In 
the Saskatoon catchment area this function of the Regional Director 
is carried out by the Head of the Department of Psychiatry at 
University Hospital. 

Service Responsibilities: 

The Head of the Department of Psychiatry is responsible for the 

provision of inpatient, outpatient, day c are, home care activities; 
as well as the provision of psychological, social work and 
occupational activities within this Department and in other 
departments of the hospital where psychiatric patients may be 
treated. This results In a number of people reporting directly to 
the Department Head; namely, the Clinical Director of 5DE, the Head 
Nurse of 5DE; Head of Social Work of 5DE; Head of Occupational 
Therapy of 5DE; Head of Clinical Psychology; Head of Division of 
Child and Youth Psychiatry; Coordinator of Community Adolescent 
Program; Head of Home Care; Coordinator of McKerracher Day Care 


Rc DONALD, Ian Maclaren 


April 27, 1982 


5 


Centre; Head of Psychiatric Services In the Student Health Centre and 
Head of Forensic Services In the Department of Psychiatry. 

Educational Activities: 

As academic Head of Psychiatry, the Department Head is responsible to 
the College of Medicine and the University of Saskatchewan for 
providing Undergraduate and Graduate Teaching Programs in Psychiatry 
in both the Medical School and for the Royal College Residency 
Training Program. The Department of Psychiatry is involved In 
teaching programs in Regina and Saskatoon. The Undergraduate 
Programs in Regina involve final year (JURSI) students. The 
Department of Psychiatry Is also responsible for providing Residency 
Training for Psychiatric Residents as well as Family Practice 
Residents in both Saskatoon and Regina. The Department is also 
involved in various outreach programs in providing continuing 
education to District Medical Societies, to Refresher Courses, and 
for In-Service Programs within University Hospital and other 

* hospitals throughout the province. 

The Department Head delegates responsibilities for the various 

educational programs to the Directors of Undergraduate Education 
(Saskatoon and Regina); to the Directors of Graduate Training in 
Psychiatry (Saskatoon and Regina); the Coordinator of Residency 
Training in Psychiatry for Family Practice (Saskatoon and Regina). 

Research: 

The Department Head is responsible for encouraging and facilitating the 
development and carrying out of research activities both at basic and 
clinical levels. As such, he has close liaison with the Research 
Division of the Psychiatric Services Branch, Department of Health, 
which is physically located within the Department of Psychiatry and 
whose senior members hold appointments in the academic department. 

Planning: 

The Department of Psychiatry is reponsibie for developing innovative 
programming in the area of psychiatric care. As such, it must work 
in close liaison with the Department of Health. In accordance with 
this working relat ionship, the Department Head and various members of 
the Department are involved in many government planning committees, 
including such areas as the provision of Forensic Services, Child and 
Youth programming, Community Care and Hospital Care. 

It should be pointed out that the Saskatoon catchment area (Mental 
Health Region) is a self-contained catchment area and may not use 
mental hospital beds at Saskatchewan Hospital, North Battleford, for 
backup. This places a very heavy service burden on the Department of 
Psychiatry, being the major inpatient resource; and, an extra burden 
on the Department Head in his joint role as Head of the University 
Hospital Department and the Medical Off Icer-in-Charge of all three 
inpatient units in the City of Saskatoon. 


McDONALD, Ian Maclaren 


April 27, 1982 


?*. CONSULTING WORK UNDERTAKEN: 

Consultant to British Columbia Department of Health re Psychiatric 
Emergency Services in Victoria, March, l?8l 

Consultant to University of B.C. re Organization of Psychiatric Services 
in the Department of Psychiatry, Health Sciences Centre Hospital, 
September to November, 1981 

2 C . DEPARTMENTAL AND COLLEGE COMMITTEES: 

Phase II Curriculum Committee, Member, 1?7^ to present 

Pharmacy Committee, Chairman 

Medical Staff, President 

Medical Advisory, Chairman 

Discipline Committee, Chairman 

Medical Audit Committee, Member 

Abortion Committee, Member 

Admissions Committee, Member, l?66-67 

Sub-Committees on Curriculum Committee and Forward Planning, Member, 

1P66 

Continuing Medical Education, Member, 1562-6^ 

Library Committee, Member, 1960-62 

2f . UN I VERS I T Y COMMITTEES: 

Advisory Committee on Student Health, Member 
Campus Committee on Alcoholism, Member 

Co-ordinating Committee, RPC, Chairman, Julv, l°8l to present 
Tenure Appeal Committee, Chairman. Mav-Julv. l?8l 

27. PROFESSIONAL AND ASSOCIATION OFFICES AND COMMITTEE ACTIVITY OUTSIDE 
UNIVERSITY: 

Member, Highwav Traffic Safetv Committee, College of Phvsicians and 
Surgeons of Saska tchewan 

Member, Mental Health Committee, College of Phvsicians and Surgeons of 
Saskatchewan 

Member, Review Panel, National Parole Service, Canada 
Member, Advisory Committee on Mental Health. Department of National 
Health and V/elfare 

Secretary, Section on Psychiatry and Federal Agencies, Canadian 
Psychiatric Association 
Member, Alcoholism Commission of Saskatchewan 
Chairman, Alcoholism Commission of Saskatchewan 
Member, Provincial Review Board 
Member, Criminal Justice Coordinating Committee 
Vice-Chairman, Liaison Committee re Establishment of Regional 

Psychiatric Centre in Saskatoon (Canadian Penitentiary Service) 
Consultant to National Parole Board 
Consultant to Canadian Penitentiary Service 

Chairman, Examining Board of Registered Psychiatric Nurses Association 
Member, Examining Board of Saskatchewan Association of Social V/orkers 
Chairman, Sub-Committee on Confidentiality for Canadian Psychiatric 


McDONALD, Ian Maclaren 


April 27, 19P2 


7 


Assoc iat ion 

Member, Consultative Group on Mental Health Research, Department of 
National Health and Welfare 
Member, Canadian Psychiatric Association 
Member, Saskatchewan Psychiatric Association 
Member, American Psychiatric Association 
Member, Canadian Medical Association 
Member, Saskatchewan Medical Association 
Member, Vanier Institute of the Family 

Chairman. Mental Health, Saskatchewan Association. Task Force, 1?P0-8l 
y Consultant to Department of Health, re PSB Programmes, 1?Pl 

Consultant to the Canadian Association of Mental Retardation. Toronto, 

1?P 1 

?R. PUBLIC AND COMMUNITY CONTRIBUTIONS: 

UNIVERSITY RELATED: 

Community Psychiatry - Central Butte, Humboldt, Rosthern 
Lectures at Saskatchewan Hospital, North Battleford 

NOT UNIVERSITY RELATED: 

Member, Alcohol Commission of Saskatchewan 
Chairman, Alcohol Commission of Saskatchewan 
Co-Director, International School of Alcohol Studies 
Mental Health Committee, Saskatchewan Medical Association 
Highway Traffic Safety Committee, Saskatchewan Medical Association 
Chairman, Task Force on Mental Health Services in Saskatchewan, Mental 
Health Saskatchewan Association, 1980-82 
Member, Working Party on Mental Health Services to the Elderly; Mental 
Health/Saskatchewan, 1?80-8l 

— — Consultant to National Institute on Mental Retardation ( New Brunswick), 

Bonner Case, February 198 O 

Consultant to Minister of Health, Rivett Enauiry, Saskatchewan Hospital. 
North Battleford, 1978 


McDONALD, Ian Maclaren 



Faculty of Medicine 

University of Toronto 


Office of the Dean 


January 9, 1986 


Mr. George T.H. Cooper 
P.0. Box 730 
1673 Bedford Row 
Halifax , N.S. B3J 2V1 

Re: ALLAN MEMORIAL INSTITUTE 
DR. D. EWEN CAMERON 

Dear Mr. Cooper: 

I am writing to provide my views on those aspects of Dr. 
Cameron's controversial treatment methods at the Allan 
Memorial Institute (1953-1964) about which you consulted me. 
I will begin by outlining the basis on which I have formed my 
opinions and then I will address the points we discussed at 
our meeting in Toronto on October 31 , 1985 and that are set 
out in your letter to me of November 26th. 


Information Base 


I have reached my conclusions on the basis of the 
following information: 

1. Review of some of the papers published by Dr. Cameron 
and his colleagues in the professional literature; 

2. Review of other contemporary professional 
publications in the same journals and in the same 
years, namely, 

a) American Journal of Psychiatry , Vol 112(1956) 

b) Canadian Psychiatric Association Journal 
Vols 6 (1961) and 10 (1965) 

c) Comprehensive Psychiatry , Vol 3 (1962) 

d) Journal of Mental Science, Vol 106 (1960) 


Cont 'd. . ./2 


Medical Sciences Building. Toromo. Ontario. MSS 1A8 


Mr. Cooper - Page Two 


January 9, 1986 


3. 


Review of unpublished personal 
Cleghorn, Dr. 

Psychiatry at 
Allan Memorial 


Cameron's succes 


McGill University 
Institute ; 


memoirs of Dr. R.A. 
sor as Professor of 
and Director of the 


4. Personal knowledge. As a medical student at McGill in 
the 1950's and an intern at the Royal Victoria 
Hospital I had some contact with Dr. Cameron and his 
work. This contact became much more extensive in 1961 
when, as a resident in Internal Medicine, I worked on 
Dr. Cameron's service at the AMI, both with his 
patients who were receiving the controversial 
treatments ( depatterning , psychic driving, 

hallucinogenic drugs, etc) and those receiving the 
more convential treatments of the day. Subsequently, 
since 1963, I have been a psychiatrist and have come 
into contact with many of Dr Cameron's colleagues, 
both admirers and critics, and have formed opinions 
about the place of his work in the development of 
psychiatry. I was a staff psychiatrist at the Allan 
Memorial Institute from 1965 through 1970 and, 
subsequently, have held senior clinical and academic 
positions in this discipline: Psychiatrist-in-Chief, 

Ottawa Civic Hospital and professorial staff, 
University of Ottawa (1971-74); Director and 

Psychiatrist-in-Chief, Clarke Institute of Psychiatry 
and Professor and Chairman, Department of Psychiatry, 
University of Toronto (1974-80). I am a member of 
the Canadian and American Psychiatric Associations, a 
Fellow of the American College of Psychiatrists and a 
member of a number of other psychiatric and 

psychoanalytic societies. Through these activities I 
have an informed, albeit personal, perspective on 
Dr. Cameron's work during the period in question. 


However, I must point out that I have not had an 
opportunity to examine any of Dr. Cameron's applications for 
research funds or research protocols, and I have not seen any 
of his former patients nor reviewed their files since leaving 
the Allan Memorial Institute. 


Cont 'd. . ./3 



Hr. Cooper - Page Three January 9, 1986 


I did not know Dr. Cameron socially, my contact being 
restricted to the professional relationship I had as a 
resident on his service for three months in 1961, during 
which time I saw him virtually daily, and occasionally 
thereafter when, as the duty resident, I might be called over 
from the Royal Victoria Hospital to assist in the medical 
aspects of the care of one of his patients. 


D. Ewen Cameron's treatments 

"Nothing that has thus far transpired is likely to 
be more serious than for humanity to learn how to 
control the development of personality and how to 
master the forces of group dynamics before we have 
developed a value system capable of dealing with 
such a s ituation . . . As psychiatrists, we are 
physicians having an immemorial responsibility for 
the well being of our patients ... Our knowledge of 
human nature, our techniques for the exploration of 
motive and memory, if torn from their framework of 
professional integrity and proper concern for the 
individual and for the community may, their use 
perverted, become the most deadly weapons yet 
directed against the dignity and serenity of human 
life" 


D.E. Cameron, 

May, 1953 

It is ironic that these words, part of his address as 
outgoing president of the American Psychiatric Association, 
were spoken by the man who is now villified in some 
newspapers and magazines and on television as an unscrupulous 
scientist, an agent or dupe of the CIA, who conducted 
"sordid" experiments on behalf of this agency using unwitting 
Canadian psychiatric patients as human guinea pigs. 


Cont 1 d. . ./4 


Mr. Cooper - Page Four 


January 9, 1986 



There can be no doubt that, in retrospect, Cameron's 
more extreme experimental treatments were misguided and 
ineffective, certainly in the long run. Controversial even at 
the time, they may have produced short term benefits for some 
patients but it is also quite possible that they resulted in 
emotional and, perhaps, organic damage to many others. I do 
not believe that any of these treatments has survived 
anywhere in the world. The treatments in question are 
primarily the following: 


1. " Depatterning " , a complex series of procedures 
designed to eradicate faulty patterns of thought and 
behaviour by producing a more primitive mode of 
functioning by the brain and mind of intractably ill 
psychiatric patients so that they could subsequently 
be "repatterned", or reprogramed, to a healthier more 
adaptive mode. Depatterning involved the use of 
multiple electroshocks repeated frequently and for a 
considerable length of time, usually following a 
period of prolonged, drug induced sleep. 

2. Powerful psychoactive disinhibiting drugs , including 
the injection of shortacting barbiturates mixed with 
amphetamines or hallucinogenic drugs (eg LSD, 
psilocybin) to attempt short cuts to psychodynamic 
understanding that would guide the content of 
"psychic driving" and advice re life changes for the 
patient. 

3. " Psychic Driving ", recorded messages with 
specifically tailored content played to the patient 
many thousand times by a variety of electronic means 
for the purpose of changing the patient's thought 
patterns and attitudes. 

4. Prolongued sensory deprivation , in which an attempt 
was made to restrict as much as possible all external 
neurosensory input so as to assist in the breaking of 
undesirable thoughts and behaviours. 


Cont 'd. . ./5 


Mr. Cooper - Page Five January 9, 1986 

None of these procedures was actually discovered by Dr. 
Cameron but their combination, and especially depatterning 
and psychic driving, were more extensively developed and used 
at the AMI than anywhere else in the world. Dr. Cameron and 
some of his colleagues reported widely on their use in 
presentations to the public and to scientific audiences and 
in extensive writings. 


Were these responsible treatments or not? 

It is not useful, in my view, to evaluate the use of 
procedures in the late 1940's, the 1950's and the early 
1960's by the application of today's standards. Certainly, 
none of these treatments could be used today in a major 
teaching hospital and they would not be supported by a 
responsible granting agency. The faulty theoretical basis for 
their use, the adverse risk-to-benef i t ratio, the poor 
evaluation methodology and the absence of provision for 
informed consent are among the factors that would militate 
against their use. 

The pertinent question is "were these procedures 
responsible from a scientific and medical point of view in 
the context of the times?" This is not easy to answer. There 
was no shortage of contemporary critics of the work. Despite 
Dr. Cameron's immense personal prestige - he was generally 
regarded as the most important psychiatrist in Canada - he 
was not successful in having these treatments widely adopted, 
in a profession that was rather prone to the premature 
adoption of promising treatments. There were many skeptics, 
even in his department at McGill. Many psychiatrists in 
Canada and abroad considered the treatment methods extreme, 
overly risky and/or without proper theoretical foundation. 
Nevertheless, it is clear that Dr. Cameron continued to be 
honoured throughout the English speaking world; he was asked 
to deliver the prestigious Maudsley Lecture in London. 


Cont d. . . /6 


Mr. Cooper - Page Six 


January 9, 1986 


He was elected President of the Canadian, American and 
World Psychiatric Associations. He attracted a large number 
of postgraduate students and visiting scholars from around 
the world, sent to him because of the respect in which he and 
his training program were held. Therefore, despite the 
controversial nature of his treatment techniques, which were 
widely reported to both the professional and the general 
public. Dr. Cameron continued to receive acclaim as a leader 
in Canadian and world psychiatry. Clearly, this could not 
have happened if his peers considered his work irresponsible. 


It must be remembered also that the treatments were 
carried out openly in one of Canada's leading teaching 
hospitals with the full knowledge of his psychiatric, 
psychological and other medical colleagues. In addition to 
receiving funding from the Society for the Investigation of 
Human Ecology, now known to have been a conduit for CIA 
funds, his work was supported by responsible national 
granting agencies. It should also be stressed that the 
Society in question was associated with Cornell University 
which was and remains a first-rate American institution of 
higher learning. 


When Dr. Cameron's papers are compared with other 
reports of therapeutic trials in the contemporary psychiatric 
literature, it is apparent that his work was no less rigorous 
than that of most of his peers. By comparison with the 
expected of therapeutic trials today, the papers 
be more descriptive and less analytical, the 
of subjects was not always rigorous or well 
the indications for the treatments were not 
out, standardized diagnostic procedures were less 
outcome criteria were not well specified, 


standards 
tend to 
selection 
described , 
clearly set 
developed , 


statistical analysis was much less sophisticated and 
follow-up information about the long term effects was either 
absent or inadequate. However, by the standards of the time, 
Dr. Cameron's work was certainly acceptable. 


Cont 'd . . ./7 



Hr. Cooper - Page Seven 


January 9, 1986 


Experiment vs. treatment 


Over the past several decades policies have evolved 
protecting the public against the premature application 
new drugs and other therapeutic procedures. In hospitals, 
particularly in university teaching hospitals, there are 

guidelines and often strict regulations that govern 

introduction of new treatments, 
and university) and professional 


for 
of 
and 
now 
the 

The institutions (hospital 
peers share responsibility 
with the attending physician for the use of controversial 
treatments in particular patients. A recognizable line is 
drawn between the application of the range of standard 
treatments and the conduct of experimental trials which 
require specific protocols and careful evaluation. During the 


1950's and 


1960 's the line was much less 


early 

faced with a sick patient, and especially one who 
to respond to standard treatment, it was much more 
physicians, on their own authority, to use 


clear. When 
had failed 
common for 
less well 

established treatments if they thought they were likely to be 
of help. A high proportion of patients were referred to Dr. 
Cameron by other physicians, including other psychiatrists, 
because their illnesses had not responded to conventioal 
treatment administered elsewhere. Many of them, both 
psychotic and severely psychoneurotic patients, were severely 
disabled, suffering considerably and at risk for suicide. At 
a time when other drastic therapeutic measures, now 
discarded, were still part of conventional therapy (e.g. 
insulin coma treatment, leucotomy and lobotomy). Dr. 
Cameron's methods were not regarded as being so extreme as 
they appear in retrospect thirty years later. 


Therefore, although with hindsight one would now regard 
Dr. Cameron's treatments as experimental and requiring 
restricted use and the most rigorous scientific evaluation 
before general application, at the time they were regarded as 
rather heroic, if extreme, attempts to help patients who were 
suffering and were not receiving benefits from conventional 
treatments. It is my own personal view that a major 
motivation for Dr. Cameron (in addition to the advancement of 
his own career) was his wish to help his patients. 


Cont ' d . . . /8 


Mr. Cooper - Page Eight 


January 9, 1986 


Medical Ethics, 1950's vs 1980's 


Fundamental ethical principles governing the practice of 
medicine have not changed during the past thirty years, 
having been established over the centuries since the 
teachings of Hippocrates, Maimonides and many others. The 
physician in Cameron's time, as now, was ethically bound to 
place the welfare of his patients above all considerations 
including personal advantage, research objectives and the 
purposes of agencies supporting the research. Further, the 
doctrine of primum non nocere (above all do no harm to the 
patient) was taught to medical students then as it is now. It 
may indeed be argued that Dr. Cameron's treatments 
transgressed both of these well accepted ethical precepts. 

The problem lies in the complexity of the issues and how 
one assesses the relevant factors. Dr. Cameron may well have 
been personally persuaded that his innovative though 
dangerous work, which brought him considerable acclaim at the 
time and notoriety later, was in the best interests of his 
patients. That is, his assessment of the benefit-risk 
equation may well have been that the application of unproven 
and risky treatments was justified because conventional 
therapy had little to offer in these cases. This is a stance 
often taken today with patients whose lives are in jeopardy 
or who are suffering intractable pain; they are offered such 
treatments as heart or liver transplants, highly toxic 
anti-cancer medication, surgical interruption of pain tracts 
in the spinal cord, and so on. Whether, in fact. Dr. Cameron 
genuinely believed that he was acting in the best interests 
of his patients is now very hard to determine. Opinions 
differ on this point, though most of those who came into 
personal contact with him believe that he did, and I share 
this view. 


Cont 'd. . ./9 


Mr. Cooper - Page Nine 


January 9, 1986 


Nevertheless, it is a valid criticism of this position 
that, as he became more and more convinced that his methods 
constituted valuable therapeutic innovations, his criteria 
for the selection of patients for these controversial 
treatments seemed to broaden. By the time I became personally 
involved wit his patients (1961) it was my own view that many 
of the schizophrenic patients who were "depatterned " had not 
had adequate trials of appropriate phenothiazine medications 
that were then available and many of the psychoneurotic 
patients who received hallucinogenic drugs and psychic 
driving could have been helped by conventional psychotherapy. 
Of course, at the time I was very junior in status and quite 
inexperienced in psychiatry; nevertheless, even in hindsight 
after more than twenty years of practicing and teaching 
psychiatry I still hold this view. 

The major change that has occurred since the 1950s with 
respect to medical ethics has been the operational 
formalization of their application in hospitals and in 
research involving human subjects. University and hospital 
ethics committees are now broadly representative, usually 
including not only physicians and other health professionals 
but also lawyers, members of the clergy and members of the 
general community. These committees now need to be persuaded 
that risky, unproven treatments are more likely to help them 
to hurt the patients, and that all possible less dangerous 
alternatives have been tried first. Ethics committees today 
will not approve research involving human subjects that is 
not scientifically valid, that is not likely to benefit the 
subjects directly or mankind generally. This was quite 
different in the 1950s when much less care was taken to 
ensure that therapeutic innovations and research involving 
humans met these criteria. Much more was left to the 
judgement of the attending physician. 


Cont 'd. . ./10 


Mr. Cooper - Page Ten January 9, 1986 


A related change has been the requirement for informed 
consent on the part of patients/subjects or, if they are 
incapable of giving this consent, on the part of appropriate 
next of kin or guardians. Hospital regulations governing both 
treatment and research now call for, first, explicit and 
detailed communication to patients or families of the 
procedures to be carried out, the rationale for their use, 
the potential risks and the alternatives available and, then, 
their informed written consent. Indeed, many research 
granting agencies require proof of this and many scientific 
journals call for explicit confirmation of informed consent 
before considering applications for research support or 
publication of manuscripts. 

During the 1950s procedures were much less stringent. 
The patient's general consent to treatment, given on 
admission to hospital, was often considered adequate to 
permit a wide range of therapeutic procedures. Consent to 
participate in research, including therapeutic trials, was 
also not nearly so rigorous as it is today. It is not 
surprising, therefore, that many persons treated by Dr. 
Cameron now claim that they were not fully informed about the 
treatments they received. The therpeutic climate of the time 
was still characterized by the assumption by patients of a 
benign paternalism on the part of the attending physician. 
This assumption would be all the greater when the physician 
was someone of Dr. Cameron's high reputation and impressive 
bearing . 

What responsibility did granting agencies have? 

This is a difficult question for me to address with 
specific reference to Dr. Cameron's work. As I pointed out 
above, I have not seen any of his research applications or 
protocols and I am not privy to correspondence with granting 
agencies or to their files. Therefore I cannot do more than 
make some general comments on this point. 


Cont ' d 


/II 


Mr Cooper - Page Eleven 


January 9, 1986 


Granting agencies 
types of safeguards to 
ethical standards are 
procedures, the dedication 
reviewers, and the integrity 


then and now have relied on three 
ensure that scientific, medical and 
high: the adequacy of their review 

and skill of expert peer 
of the applicants for research 


support. Granting 
appropriate 
( including 
methods of 
experts in 
importance 


agencies must ensure that they 


requ 1 re 

information about the research proposed 
the rationale, the research methods, and the 
data analysis); that the proposal is reviewed by 
the field from the points of view of relevance, 
and scientific validity; and that grantees have 
the appropriate professional and scientific qualifications 
and reputation. The only difference today is that these 
criteria are better operationalized and that informed consent 
of subjects is now specifically required. 


Of course, granting agencies that rely on fallible 
people to establish procedures and conduct peer review of the 
proposals received make mistakes. They sometimes support 
research that is scientifically unworthy, or of low relevance 
to society or ethically flawed. Furthermore, once the 
agencies grant financial support they must rely on the 
grantee to conduct the research as it was proposed and 
approved and according to high scientific and ethical 
standards . 

Obviously once a granting agency becomes aware that the 
research is seriously deficient in any of these areas it will 
not likely fund further applications. Grantees who 
receive renewals of research support are considered by the 
agencies as scientifically and ethically worthy. 


A further safeguard is in the subsequent publication of 
the work. The major medical and scientific journals all have 
careful peer review procedures for selecting manuscripts for 
publication. Granting agencies usually will not renew grants 
or award new ones to investigators who are not able to get 
their work published in peer-reviewed journals. That is, a 
second group of peers, often in another country, review the 
work for scientific merit, relevance and ethical standards. 


Cont ' d . . ./12 


Mr. Cooper - Page Twelve 


January 9, 1986 


fact that two groups 
professional advisory 


of 

or 


experts 

review 



The 
agency ' s 

journal's peer reviewers, continued to 
applications and manuscripts indicates that his professional 
peers were satisfied that the scientific, medical and ethical 
standards of the day were met. 


Summary 

In summary, it is my opinion that: 

1. Dr. Cameron's controversial treatments (depatterning , 
psychic driving, prolonged sleep therapy, prolonged 
sensory deprivation and use of hallucinogenic drugs) 
were ineffective and, in retrospect, inadvisable. 

2. They were, however, medically acceptable in the 
context of the times. 


3. They were also, in that context, generally regarded 
as extreme attempts to help patients who were not 
benefitting from more conventional treatments; that 
is, they were not generally considered irresponsible. 

4. Whether Dr. Cameron's treatments transgressed medical 
ethical standards is arguable. He probably was 
personally persuaded that his treatments were in the 
best interests of the patients in that the possible 
benefits and lack of effective alternative treatments 
outweighed the risks. This is clearly a matter of 
debate . 


5. The lack of insufficiently informed consent for the 
procedures on the part of some of Dr. Cameron's 
patients was not unusual in the context of the 
practices of the times. 


Cont'd. . ./13 


Mr. Cooper - Page Thirteen 


January 9, 1986 


6. Research granting agencies, then as now, depend 
heavily on the judgement of peers and the integrity 
of the grantee for the maintenance of high 
scientific, medical and ethical standards. In 
addition to the controversial support by the Society 
for the Investigation of Human Ecology, responsible 
national granting agencies evaluated Dr. Cameron's 
proposals and responsible psychiatric journals 
published his manuscripts after they were subjected 
to peer review. 

Dr. Cameron's professional peers were well aware of 
the treatments he carried out and yet they bestowed 
upon him acclaim as well as criticism, honours and 
high professional offices. 

I hope that my opinions will be useful in the 
preparation of your report to the Honourable John Crosbie, 
Minister of Justice of Canada. 


Yours sincerely, 



Dean 


FHL/ses 


CURRICULUM VITAE 


Frederick H. Lowy 


Personal 


Born: January 1, 1933, Grosspeter6dorf , Austria 
Canadian Citizenship: December 2, 1950 
Married: Wife - Mary Kay O'Neil-Lowy, PhD; 4 children 
Address: 338 Inglewood Drive 

Toronto Ontario M4T 1J6 
Telephone: 482-4063 (home) 

978-6584 (office) 


Present Positions 


1980- Dean, Faculty of Medicine, University of Toronto 
1974- Professor, Department of Psychiatry, University of Toronto 
1985- Vice-President, Association of Canadian Medical Colleges 
1985- Chairman, Council of Ontario Faculties of Medicine 


Other Appointments 


1973- 

1975- 

1975- 

1975- 

1975- 

1975- 

1975- 

1975- 

1975- 

1975- 

1975- 

1980- 

1981- 
1981- 
1984- 
1984- 
1984- 
1984- 


Con6ultant, Ontario Cancer Institute 
Consultant, Addiction Research Foundation 
Consultant, Mount Sinai Hospital 
Consultant, North York General Hospital 
Consultant, Princess Margaret Hospital 
Sunnybrook Medical Centre 
St. Michael's Hospital 
Toronto General Hospital 
Toronto Western Hospital 
Women's College Hospital 
Consultant, Wellesley Hospital 
Consultant, Clarke Institute of Psychiatry 
Member, Board of Trustees, Sunnybrook Medical Centre 
Board of Trustees, Ontario Cancer Institute 
Board of Trustees, Mount Sinai Hospital 
Board of Trustees, Toronto General Hospital 
Board of Trustees, Toronto Western Hospital 
Board of Trustees, Eye Research Institute of Ontario 


Consultant , 
Consultant , 
Consultant , 
Consultant , 
Consultant , 


Member, 

Member, 

Member, 

Member, 

Member, 


Education 


1. Elementary schools in Lisbon, Philadelphia, Montreal. 

2. Baron Byng High School, Montreal, 1946-50 

3. Machon Lemadrichei Chutz Laaretz 

(Institute for Youth Leaders from Abroad), Jerusalem, 
Israel, 1952-53 

4. McGill University, Faculty of Arts 1950-52, 1953-55 

5. McGill University, Faculty of Medicine, 1955-59 


Academic and Professional Qualifications 

1955 B.A. (Psychology), McGill University, Montreal 
1959 M.D. , C.M., McGill University 

1959 Licensee, Medical Council of Canada 

1960 Licensee, National Board of Medical Examiners, USA 

1965 Certificant in Psychiatry, Royal College of Physicians and Surgeons 
of Canada - CRCP (C) 

1967 Diplomate, American Board of Psychiatry and Neurology 

1970 Graduate, Canadian Institute of Psychoanalysis 

1971 Fellow, Royal College of Physicians and Surgeons - FRCP (C) 


Professional Post Graduate Education 


1959- 60 Rotating internship, Royal Victoria Hospital, Montreal 

1960- 61 Junior Assistant Resident in Medicine, Royal Victoria Hospital, 

Montreal 

1962-64 Resident in Psychiatry, University of Cincinnati College of 
Medicine and related hospitals, Cincinnati, Ohio 

1964-65 Chief Resident in Psychiatry, Cincinnati General Hospital 
and Veteran's Administration Hospital, Cincinnati, Ohio 
1966-70 Training in Psychoanalysis, Canadian Institute of Psychoanalysis, 
Montreal 


Previous Appointments - University 

1965- 66 Demonstrator, Department of Psychiatry, McGill University 

1966- 68 Lecturer, Department of Psychiatry, McGill University 
1968-70 Assistant Professor of Psychiatry, McGill University 
1971-72 Associate Professor of Psychiatry, University of Ottawa 

1973- 74 Professor, Department of Psychiatry, University of Ottawa 

1974- 80 Professor and Chairman, Department of Psychiatry, University 

of Toronto 


Previous Appointments - Hospital 


- 3 - 


1965-67 Clinical Assistant in Psychiatry, Royal Victoria Hospital, Allan 
Memorial Institute, Montreal 

1967-69 Assistant Psychiatrist, Royal Victoria Hospital, Montreal 
1969-70 Associate Psychiatrist, Royal Victoria Hospital, Montreal 
1971-74 Psychiatrlst-in-Chief , Ottawa Civic Hospital 

1971-80 Director and Psychiatrist-in-Chief, Clarke Institute of 
Psychiatry, 

Toronto 


Professional Editorial Posts 


1971-72 

1973- 76 

1974- 76 

1976- 

1977- 

1978- 

1978- 

1983- 


Associate Editor - Canadian Psychiatric Association Journal 
Editor - Canadian Psychiatric Association Journal (now Canadian 
Journal of Psychiatry) 

Editorial Board - Canada's Mental Health 
Editor Emeritus, Canadian Journal of Psychiatry 
Editorial Board, Montage 

Corresponding Editor - The International Journal of Psychiatry 
in Medicine 

Editorial Board - Psychiatry, Medicine and Primary Care 
Editorial Board - Social Psychiatry 


Research Positions 


Director, Sleep and Dream Laboratory, Allan Memorial Institute, Montreal. 

from its organization in May 1967, until December 1970. 

Head, Psychotherapy Research Section - Clarke Institute of Psychiatry, 
from its organziation in 1978 to 1980. 


Major Organizational and Administrative Appointments 
Premedical 

President, Student's Council, Baron Byng High School, Montreal 1949 

Managing Editor (1953) and Editor (1954) McGill Daily 

Student's Executive Council, McGill University (1953-54 and 1958-59) 


Medical (Undergraduate) 

Editor, CAMSI Journal (Canadian Association of Medical Students and 
Interns) 1958-59 

President, McGill Medical Class of '59'. 


4 


Medical (Post graduation) 

Member, Development Committee, Royal Victoria Hospital, Montreal, 1968*70. 
Secretary, Consortium of Faculty, Department of Psychiatry, McCill 
University 1969-70. 

Program Chairman, 7th Annual Convention, Quebec Psychiatric Association 
1971 

Member, Medical Advisory Committee, Ottawa Civic Hospital, 1971-74. 
Secretary, Medical Advisory Committee, Ottawa Civic Hospital, 1973-74. 
Member, Executive Committee, Ottawa Civic Hospital, 1973-74. 

Chairman, Credentials Committee, Ottawa Civic Hospital, 1973-74. 

Member, Task Force on Demonstration Model Grants, Health Research 
Committee, Ontario Council of Health, 1972-74 
Member, Advisory Board, Ontario Mental Health Foundation, 1972-78 
Member, Search Committee for Chairman of Psychiatry, University of Ottawa, 
1973 

Member, Examining Board (Psychiatry), Royal College of Physicians and 
Surgeons of Canada, 1972-77. (Chairman - 1975-77) 

Member, Executive Committee and Dean's Senior Advisory Committee, Faculty 
of Medicine, University of Toronto (1976-78) 

Member, Program Committee, American Psychiatric Association (1976-80) 
Nucleus Member, Speciality Committee, Royal College of Physicians and 
Surgeons of Canada (1977-81) 

Reviewer, Department of Psychiatry, University of British Columbia, 1979 
Reviewer, (for Royal College), University of Montreal, 1980 
Reviewer, Department of Psychiatry, McMaster University, 1983 
Reviewer, Department of Psychiatry, Queen's University, 1984 
Consultant, Sultan Qaboos University, Sultanate of Oman, 1984 
Member, Council of Ontario Faculties of Medicine (1980-) 

Vice-Chairman, Council of Ontario Faculties of Medicine (1983- ) 

Member, Senior Advisory Group, University of Toronto (1982- ) 

Member, Executive, Association of Canadian Medical Colleges (1982- ) 

Member, Board of Regents, American College of Psychoanalysts (1983-85) 


Societies 


Alpha Omega Alpha 

Canadian Medical Association 

Canadian Psychiatric Association 

Ontario Psychiatric Association 

Canadian Psychoanalytic Society 

International Psycho-Analytical Association 

American Psychiatric Association (Fellow) 

American College of Psychiatrists (Fellow) 

American College of Psychoanalysts (Fellow) 

American Psychosomatic Society 

Association for Psychophysiological Study of Sleep and Dreams 
American Association for the Advancement of Science 
International College of Psycosomatic Medicine (Fellow) 
Academy of Medicine, Toronto 
Society for Psychotherapy Research 


Honours 


Dr. F.R. Eccles Memorial Lecturer, University of Western Ontario February 

1975 

Fellow, American Psychiatric Association, 1975 

Fellow, American College of Psychiatry, 1979 

Fellow, American College of Psychoanalysts, 1979 

Fellow, International College of Psychosomatic Medicine, 1979 

Member, Benjamin Rush Society (USA), 1981 

Award of Merit, McGill Society of Toronto, 1984 

Major Presentations at Scientific Meetings and Invited Lectures 

1964: - (with H.W. Wylie, Jr. and P. Lazaroff): The Death of a Patient 

in a Psychotherapy Group. Annual meeting, American Group Psychotherapy 
Association, New York, January 1964. 

1967: - (with Z.J. Lipowski): The Alm6 and Techniques of Psychiatric 

Consultation in Medicine. Annual meeting, Canadian Psychiatric 
Association, Quebec, June 15, 1967. 

1968: ~ (with R.M. Wintrob and B.K. Dhindsa): Man and his Anxiety. Annual 
meeting, Quebec Psychiatric Association, Montreal, May 3, 1968. 

1969: - (with R.A.H. Kinch, B.K. Lewis, R.N. MacDonald and C.R. Scriver): 

The Teaching of Behaviour, Growth and Development in the Preclinical 
Years of Medicine. Annual meeting, Quebec Psychiatric Association, 
Quebec, May 22, 1969 


1969: - (with R.M. Wintrob, B. Borwick, G. Garmaise and H.O. King): 

A Follow-up study of Emergency Psychiatric Patients and Their 
Families: Methodological Problems. Annual meeting, Canadian Psychiatric 
Association, Toronto, June 11, 1969. 

1970: - (with T.K. Kolivakis): Autocastration by a Male Transsexual: Case 

Report and Some Notes on the Management of Transsexualism. Annual 
meeting, Canadian Psychiatric Association, Winnipeg June 19, 

1970. 


6 


1970: ■ Is Abreaction Always Desirable? The Misuse of an Early Psychoanalystic 
Concept. Group without a Name Psychiatric Research Society, Montreal, 
October 16, 1970. 

- Tetrahydrocannabinol and Sleep. Joint meeting, Montreal Physiological 
Society and Medicinal Chemists Division of Chemical Institute 
of Canada, Pointe Claire, Ottawa, January 23, 1971 

- (with R. Broughton and J. St. Laurent): Significance for Psychiatrists 
of Current Sleep and Dream Research. Annual meeting, Quebec Psychiatric 
Association, Sherbrooke, Quebec April 22, 1971 

- (with B. Humphrey, P. Beck, D.J. Lewis, A. Schwartzman and L. Stephens): 
Response to a Medicare Strike in a Psychiatric Hospital. Annual 
meeting, Canadian Psychiatric Association, Halifax, June 12, 1971. 

1972: - Patients who Somatize, Annual meeting, Ontario Psychiatric 
Association, Toronto, January 29, 1972 

- Psychoanalytic Dream Theory in the Light of Recent Dream Research, 

Ottawa Psychoanalytic Group, March 27, 1972 

- Research on Dreams - Some Current Issues. Ottawa Academy of Medicine, 
Section on Psychiatry, April 4, 1972 

- The Psychology of Sleep - Some Current Issues. First Canadian 
International Symposium on Sleep. McGill University, Montreal, 

April 14, 1972. 

- The Psychiatrist-Physician Relationship in General Hospitals: Present 

and Future. Annual meeting, Ontario Medical Association. Toronto, 

Bay 11, 1972. 

- Clinical Dream Interpretation in the Light of Modern Sleep Research. 
Ontario Psychiatric Association, Huntsville, September 30, 1972. 


1973: - (with R. Melzack, R. Nelson and E. Peterson): 

Current Concepts of Pain Mechanisms. Ottawa Neurosciences 
Society, November 15, 1973 


1974: - The Chronic Somatizer - Treatment Strategies. Maurice Levine 
Society, University of Cincinnati, Cincinnati, Ohio, 

October 12, 1974 

1975: - Strategies in the Management of Chronic Pain. The Dr. F. R. 

Eccles Memorial Lecture, University of Western Ontario, 

London, February 5, 1975 

- Psychiatric Aspects of Pain. Invited Lecture University of 
Connecticut Health Centre, Department of Psychiatry, April 
16, 1975 

1976: - The Impact of Community Psychiatry on Psychiatric Teaching. 
Association of Psychiatric Outpatient Centers of America, 
Montreal, June 4, 1976 

1977: - Issues in the Treatability of the Neuroses. Invited address, 
Ontario Psychological Association, February 11, 1977 

1978: - (with E.F Guirguis, H.B. Durost, J.T.D. Glaister, J.J. Jeffries 
and G. Warme): The Use of Mechanical Restraints: Current Status. 
Ontario Psychiatric Association, January 26, 1978 

- A Reconsideration of Agoraphobia. Canadian Psychoanalytic 
Society, Toronto, March 28, 1978 

- Seldom Discussed Issues in Psychotherapy. Annual Meeting Canadian 
Psychiatric Association, Halifax, October 18, 1978 


1979: - Some Remarks on Epidemic Hysteria. Invited Lecture, 

Cincinnati Psychiatric Society, Cincinnati, Ohio, 

May 2, 1979 

- (with S. Greben, R. Smith, P. Steinhauer and G. Voineskos): 

The Psychiatric Training of Medical Students: Current Issues 
and Future Directions. Annual Meeting, Canadian Psychiatric 
Association, September 26, 1979 

1980: - Psychotherapy for the 1980' s. Invited Address to the Annual Meeting, 
Association of Psychiatric Outpatient Centers of America, June 
1980 


8 


1961i * (vith S. Ho6enbocu6, P. Leichner, H. Prosen and H. Kravits): 

The Oral Certification Examination in Psychiatry. Annual 
Meeting, Canadian Psychiatric Association, Winnipeg. 

September 23, 1981 

- (vith F.G. Sommers, J.D. Griffin, and R.O. Jones): Medical 

and Psychological Effects of Nuclear War and the Nuclear Arms 
Race. Annual Meeting, Canadian Psychiatric Association, 

Winnipeg, September 24, 1981 

- (vith J.M. Cleghorn and V.M. Rakoff): The Role of Psychoanalysis 
in Contemporary Psychiatric Training. Annual Meeting, Canadian 
Psychiatric Association, Winnipeg, September 25, 1981 

1982: - The Use and Abuse of Drugs in the Treatment of Anxiety. 

Saudi Arabian Annual Medical Meeting, King Faisal University, 
Dammam, Saudi Arabia. 

- (vith J.M. Cleghorn): P6ychodynamics in the Training of Psychiatric 
Residents. Annual Meeting, American College of Psychoanalysts, 
May 15, 1982 

- Psychotherapy: A Personal View. Academy of Medicine, Toronto, 
December 9, 1982 

1983: - Psychotherapy and the Education of Psychiatrists. 

Invited Lecture, Montreal General Hospital and McGill University 
Department of Psychiatry. Montreal, April 15, 1983 

- The Mission of the Physician: The Relationship of Science to 
Har-an Values. The Edward Brooks Memorial Lecture, St. Michael' 6 
Hospital, Toronto, June 23, 1983 

- The Status of Psychotherapy Today. Invited Lecture, Department 
of Psychiatry, University of Manitoba, Winnipeg, October 

4, 1983 


1984: The Impaired Physician: The Role of the Medical School. Annual 

Meeting, The Royal College of Physicians & Surgeons, Montreal, 
September 12, 1984 


9 


External Teaching and Lecturing 
since coming to Toronto 


1974 

1975 


1976 


1977 

1978 

1979 

1980 

1982 

1983 


1984 


University of Ottawa 
University of Cincinnati 

University of Western Ontario 
University of Connecticut 
Dalhousie University 
McGill University 

McGill University 

St. Vincent's Hospital 

National University of Ireland, Dublin 

Memorial University of Newfoundland 

University of British Columbia 

University of Ottawa 

University of Cincinnati 

McMaster University 

King Faisal University, 

Dammam, Saudi Arabia 

McGill University 
University of Manitoba 
Beijing Hospital, Beijing China 
Sichuan Medical College, Chengdu China 


McGill University 


* 10 


Publications 


A. In Books 

1972 1 Lowy, F.H. i The Psychology of Sleep - Some Current Issues. 

In McClure, D.J. (Ed) First Canadian International Symposium 
on Sleep: Proceedings April, 1972. Roche Scientific Service, 

Hoffman - LaRoche, Vaudreuil, Quebec, 1972 

1976s Lovy, F.H.s Delirium: Method of Treatment. In Current Therapy 
837-839, Ed by H.G. Conn, Philadelphia: W.B. Saunders 6i Co. 1976 

1977: Lovy, F.H.: Management of a Persistent Somatizer. Psychosomatic 
Medicine Z.J. Lipowski, D.R. Lipsitt, P.C. Whybrow (Ed6> 

New York: Oxford University Press, 1977 

1978: Lovy, F.H. : The Impact of Community Psychiatry on Psychiatric 

Teaching. In J.M. Divic and M. Dinoff (eds) Community Psychiatry 
- Review and Preview University of Alabama Press 

1978: Lovy, F.H.: Case Discu66ion, in H. Davanloo (Ed) 

Basic Principles and Techniques in Short-Term Dynamic Psychotherapy 
Jamaica, N.Y. : Spectrum Publications, 1978 

1979: Lovy, F.H.: The Pendulum Swings from Society to the Individual, 

in D.K. Weisstub (Ed) Law and Psychiatry II , New York: 

Pergamon, 1979 

1979: Lowy, F.H.: Full Cycle in Child Mental Health. In S.J. Shamsie 
(ed) New Directions in Children* s Mental Health Jamaica N.Y.: 

Spectrum Publications, 1979 

1980: Lowy, F.H.: The Use of Drugs and Other Treatments in Depression 
in F.J. Ayd (Ed) Clinical Depressions: Diagnostic and Therapeutic 
Challenges , 1980 

1980: Greben, S.E., Pos , R. , Rakoff, V., Bonkalo, A., Lowy, F.H., and 
Voineskos, G. (Eds) A Method of Psychiatry Philadelphia: 

Lea & Febiger, 1980 375 pages. 

1980: Voineskos, G. and Lowy, F.H.: Psychiatric Emergencies. In S.E. 

Greben et al. A Method of Psychiatry pp 267-274 


11 


1980: Voinesko6 G. and Lovy, F.H.: Suicide and Attempted Suicide. 

In S.E. Greben et al. A Method of Psychiatry pp 275-280 

1980: Lovy, F.H.: Psychiatric Treatment: General. In S.E. Greben et al. 
A Method of Psychiatry pp 281-288 

1980: Lovy, F.H. and Po6 , R.: Psychotherapy and Behavior Therapy, 

In S.E. Greben et al. A Method of Psychiatry , pp 289-296 


I960: Lovy, F.H.: Referral to the Psychiatrist. In S.E. Greben et al. 

A Method of Psychiatry , pp 339-344 

1984: Lovy , F.H.: Treatment of the Anxiety Disorders, Somatoform 
Disorders, Dissociative Disorders and Personality Disorders. 

In Endler, N.S. and Hunt H. McV. Personality and Behaviour 
Disorders , 2nd Edition New York: John Wiley & Sons, 1984 

1984: Lovy, F.H. : Anorexia Nervosa: a paradigm for mind-body 

interdependence? In Darby, P.L., Garfinkel, P.E., Garner, D.M., 
and Coscina, D.V. (Eds) Anorexia Nervosa: Recent Developments 
in Research , New York: Allan R. Liss 1984. 

1985: Voineskos, G. and Lovy, F.H. : Psychiatric Emergencies in Greben, 
S.E. , Rakoff, V.M. and Voineskos, G. A Method of Psychiatry, 2nd 
Edition , Philadelphia: Lea & Febiger, 1985 

1985: Voineskos, G. and Lowy, F.H. Suicide and Attempted Suicide, in 

Greben, S.E., Rakoff, V.M. and Voineskos, G. A Method of Psychiatry, 
2nd Edition , Philadelphia: Lea & Febiger, 1985. 


1985: Lovy, F.H. : Referral to the Psychiatrist. In Greben, S.E., Rakoff, 

V.M. and Voineskos, G. A Method of Psychiatry, 2nd Edition , Philadelphia: 
Lea & Febiger, 1985. 


12 


B. In Refereed Journals 

1957: Lambert, W.E. and Lovy, F.H.: Effects of the Presence and 
Discussion of Others on Expressed Attitudes. 

Canadian Psychol. II: 151-163, 1957 

1964: Wylie, H.W. Jr., Lazoroff, P. and Lovy, F.H.: A Dying Patient 
in a Psychotherapy Group. Internat. J. Group Psychother. 

14: 482-490, 1964 

1965: Lovy, F.H. : The Neuropsychiatric Complications of Viral Hepatitis, 

Canad. Med. Assoc J. 92: 237-239, 1965. 

1969: Lovy, F.H. , Wintrob, R.M. and Dhindsa, B.K.: Psychiatric 
Emergencies at Expo '67, Canada. Psychiat. Assoc. J. 

14: 47-52, 1969 

1969: Lovy, F.H. , Wintrob, R.M. and Dhindsa, B.K.: Man and his 
Anxiety. Laval Medical 40: 966-970, 1969 

1970: Lovy, F.H., Recent Sleep and Dream Research: Clinical Implications 
Canadian Medical Assoc. J. 102: 1069-1077, 1970 

1970: Lovy, F.H. : Sleep Research and Scientific Change. Canadian 
Med. Assoc. J. 102: 1105-1106, 1970 (unsigned editorial) 

1970: Kinch, R.A.H., Lewis, D.J., Lovy, F.H. , MacDonald, R.N. and 

Scriver, M.D.: The Teaching of Behaviour, Growth and Development 
in the Preclinical Years of Medicine. Laval Medical 41: 

495-499, 1970. Also published in Milbank Memorial Fund 
Quarterly 49: 228-243 (April) 1970 

1970: Lovy, F.H.: The Abuse of Abreaction: An Unhappy Legacy of 
Freud's Cathartic Method. Canad. Psychiat. Assoc J. 15: 

557-567, 1970 

1970: Levis, D.J. and Lovy, F.H.: The Well-Tempered Psychiatrist: 

Robert Allan Cleghorn, M.D. Canad. Psychiat. Assoc. J. 15: 513-514, 

1970 

1971: Lovy, F.H. , Wintrob, R.M. , Borvick, B., Garmaise, G. and King, 

H.O. : A Follow-up Study of Emergency Psychiatric Patients and 
their Families: Methodological Problems. Comprehensive Psychiat. 

12* 36-47, 1971 


1971: Lovy, F.H.: Lessons from Emergencies: Canad. Psychiat. Assoc. J. 
16: 103-104, 1971 


- 13 - 

1971s Lovy, F.H., Cleghorn, J.M. and McClure, D.J.: Sleep Patterns 
in Depression. J. Nerv. Ment. Pis. 153: 10-26, 1971 

1971: Levy, F.H.: New Directions in Dream Psychology Research 
Canad. Psychlat. Assoc. J. 16: 399-406, 1971 

1971: Lovy, F.H. and Kolivakis, T.K.: Autocastration by a Male 

Transsexual. Canadian Psychiat. Assoc. J, 16: 399-406, 1971 

1971: Cleghorn, R.A. , Cleghorn, J.M. and Lovy F.H.: Contributions 
of behavioural Sciences to Health Care. 

Milbank Memorial Fund Quart. 49: 158-174, 1971 

1973: Lovy, F.H. , Engelsmann, F. and Lipovski, Z.J.: Study of Cognitive 
Functioning in a Medical Population. 

Comprehensive Psychiatry, 14: 331-337, 1973 

1973: Lovy, F.H. : Psychiatric Research. Canad. Psychiat. Assoc. J. 

18: 91-92, 1973 

1974: Lovy, F.H.: Renaissance of Psychiatric Diagnosis. 

Canad. Psychiat. Assoc. J. 19: 233-254, 1974 

1975: Lowy, F.H. : Editorial: Clarence B. Farrar, 1874-1970, and the 
History of Psychiatry in Canada. Canad. Psychiat. Assoc. J. 

20: 1-2, 1975 

1975: Lowy, F.H.: Management of the Persistent Somatizer. 

International Journal of Psychiatry in Medicine 
6: 227-239, 1975 

1976: Lowy, F.H.: The State of the Specialty. Canad. Psychiat. Assoc. 

J^ 21: 504-505, 1976 

1979: Lowy, F.H. and Jones R.O.: The Canadian Certification Examination 
in Psychiatry I - Historical Notes. Canad. J. Psychiatry 
24: (4), 1979 

1979: Lowy, F.H. and Dongier, M. : The Canadian Certification Examination 
in Psychiatry II - Who Passes and Who Fails. Canad. J. Psychiatry 
24: (4) 1979 

1979: Lowy, F.H. and Prosen, H. : The Canadian Certification in 
Psychiatry III - Towards Better Certification Techniques 
Canad. J. Psychiatry 24: (4) 1979 

1980: Lowy, F.H. and Thornton, J. : To be or not to be a psychiatric chief 
resident: Factors in Selection. Canad. J. Psychiatry 
25: 121-126, 1980 


1981. B 
l 

1981. 1 
1 


1981. 


1984: 


14 


1981 1 Ban, T.A., Brown, W.T., Da Silva, T. , Gagnon, M. , Lamond, C.T., 

LcbaAnn , H *E • , Lowy , F • H • , Rutdy , J » , S® 1 lcn , £ «M* i Canad . Me d . 

Aaaoc . J. 124: 1439-1446, 1981 

1981 1 Lipptnann, D.H., Lowy, F.H., and Rickhi, B.i Attitudes of Ontario 
Psychiatrists towards health insurance. Canad. Med. Assoc. J. 

125: 167-170, 1980 

1981: Voineskos, G., Greben, S.E., Lowy, F.H., Smith, F.L., and Steinhauer, 

P.D. : The psychiatric training of medical students. Canad. J. Psychiatry 
26: 301-308, 1981 

1984: Roacarl, D.A.K., Salter, R.B., Till, J.R., and Lowy, F.H.: 

Is the clinician-scientist really vanishing? Encouraging results 
from a Canadian institute of medical science, Canad. Med. Assoc. 

J. 130: 977-979, 1984 


15 


C. In Other Journals and Periodicals 

1972i Lovy , F.H.: The Psychiatrist-Physician Relationship in General 
Hospitals: Present and Future. Ontario Medical Review , 727-732, 
December 1972 

1975: Berg, J.M., Lovy, F.H.: XYY Syndrome: A comment. Modern Medicine 
of Canada . 30: 8, 692-693, August, 1975 

1979: Editorial Board - A Resident's Guide to Psychiatric Education 
M.G.G. Thompson (Ed) New York: Plenum Publishing, 1979 

1979: Lovy, F.H.: The Neurosciences at the Clarke Institute of Psychiatry. 
Trends in Neuroscience. 2: X-XI , October, 1979 

1981: Lovy, F.H.: The Future Physician: Labyrinth of Expectations. 

The Medical Graduate 26: 5-7, 1981 

1981: Lovy, F.H.: The Dean's Challenge. University of Toronto Medical 
Journal , January 1982. pp 34-37 

1982: Lovy, F.H.: The Alumni and the Faculty: Why Support Human 
Nutrition. The Medical Graduate 27: 4-5, 1982 

1982: Lovy, F.H.: Preventing the Ultimate Epidemic, Re: Action 
(Canad. Mental Health Assoc.) Fall, 1982 

1983: Lovy, F.H.: Psychotherapy in the 1980's POCA Press: 15: 13-19, 

1983 (Psychiatric Outpatient Centres of America) 

1983: Lovy, F.H.: The Faculty looks to the Alumni, The Medical Graduate 
28, 4-5, 1983 

1984: Lovy, F.H.: Tovards Better Communication, Tablet (Fac. of Med, 

U. of T.) 1, 1-2, 1984 

1985: Lovy, F.H. On Communication and Research, Tablet (Fac. of Med, 

U. of T.) Vol 1, No. 2, p 3 

1985: Lovy, F.H. From Competence to the Pursuit of Excellence, Tablet 
(Faculty of Medicine, University of Toronto Vol 1, No. 3, p 2. 

Lovy, F.H. The 1985 Noble Peace Prize, Tablet (Faculty of Medicine, 
University of Toronto) Vol 1, No. 4, P 2. 


1985: